Instructions

Carefully follow the instructions for preparing this medicine before injection.

The medicine needs to be mixed before being injected.

Dilute with sterile water for injection, as directed.

Do not mix this medicine with other solutions.

Always inspect the medicine before using.

The liquid should be clear and colorless.

Do not use the medicine if it contains any particles or if it has changed color.

Do not shake the medicine before using.

Store new medicine in the refrigerator until you are ready to use it. Do not allow them to freeze.

If the medicine becomes frozen, you will need to throw it away.

Protect medicine from light.

Warm refrigerated medicine by gently rolling the vial between the palms of your hand for about 1 minute. Do not shake the vial.

Inject the medicine immediately after mixing.

Injecting cold drug may be uncomfortable.

Never use any medicine that has expired.

Discard unused diluted medicine after 24 hours.

Ask your doctor, nurse or pharmacist to show you how to use this medicine correctly.

Avoid injecting the medicine within 2 inches around the navel.

Do not inject into skin that is red, swollen or itchy.

Change the location of the injection each time. Choose a location at least 1 inch from the last injection.

Do not rub or massage the area where the injection was given.

To relieve dry mouth, chew gum, suck on hard candy/ice chips, drink extra water, or use a saliva substitute.

It is important that you keep taking each dose of this medicine on time even if you are feeling well.

If you forget to take a dose on time, take it as soon as you remember. If it is almost time for the next dose, do not take the missed dose. Return to your normal schedule. Do not take 2 doses at one time.

Drug interactions can change how medicines work or increase risk for side effects. Tell your health care providers about all medicines taken. Include prescription and over-the-counter medicines, vitamins, and herbal medicines. Speak with your doctor or pharmacist before starting or stopping any medicine.

Tell your doctor if symptoms do not get better or if they get worse.

Your doctor may prescribe other medications to reduce side effects. Follow instructions carefully.

Pain or fever reducers may relieve some side effects. Please speak with your healthcare provider or pharmacist.

Visit your dentist regularly. Proper care of your teeth is very important while taking this medicine. Brush your teeth and floss regularly.

Keep all appointments for medical exams and tests while on this medicine.

Cautions

During pregnancy, this medicine should be used only when clearly needed. Talk to your doctor about the risks and benefits.

Tell your doctor and pharmacist if you ever had an allergic reaction to a medicine.

Some patients on this medicine have developed severe, life-threatening infections. Please speak with your doctor about the risks and benefits of using this medicine.

Do not use the medication any more than instructed.

Your ability to stay alert or to react quickly may be impaired by this medicine. Do not drive or operate machinery until you know how this medicine will affect you.

If possible, avoid using with alcohol, marijuana, or other medicines that can cause dizziness or drowsiness. These include allergy/cold products, muscle relaxers, sleep aids, and pain relievers.

After being on this medication, speak with your doctor about any new, unusual or strong thoughts or feelings.

This medicine may reduce your body's ability to fight infections. Avoid contact with people with colds, flu or other infections. Contact your doctor if you develop fever, cough, sore throat, or chills.

Speak with your health care provider before receiving any vaccinations.

It is unknown if this medicine passes into breast milk. Ask your doctor before breastfeeding.

Ask your doctor, nurse or pharmacist how to safely discard unused medicines, needles and syringes.

Do not share this medicine with anyone who has not been prescribed this medicine.

Some patients have serious side effects from this medicine. Ask your pharmacist to show you the information from the Food and Drug Administration (FDA) and discuss it with you.

Side Effects

The following is a list of some common side effects from this medicine. Please speak with your doctor about what you should do if you experience these or other side effects.

• decreased appetite
• back pain
• diarrhea
• dizziness
• lack of energy and tiredness
• flu-like symptoms
• hair loss
• headaches
• pain, redness, swelling near injection
• nausea and vomiting
• stomach upset or abdominal pain
• changes in taste or unpleasant taste

Call your doctor or get medical help right away if you notice any of these more serious side effects:

• agitated feeling or trouble sleeping
• decreased awareness or responsiveness
• bleeding that is severe or takes longer to stop
• chest pain
• changes in memory, mood, or thinking
• depression or feeling sad
• swelling of the face, mouth, tongue, or throat
• swelling of the legs, feet, and hands
• fever or chills
• numbness or tingling in hands and feet
• severe or persistent headache
• fast or irregular heart beats
• irritability
• signs of liver damage (such as yellowing of eye or skin, dark urine, or unusual tiredness)
• menstruation changes (missed or fewer periods)
• seizures
• shakiness
• shortness of breath
• dark, tarry stool
• symptoms of stroke (such as one-sided weakness, slurred speech, confusion)
• difficulty adjusting to changes in temperature
• persistent or unusual thirst
• increased urinary frequency
• blurring or changes of vision
• weight loss

A few people may have an allergic reaction to this medicine. Symptoms can include difficulty breathing, skin rash, itching, swelling, or severe dizziness. If you notice any of these symptoms, seek medical help quickly.