1. Assembly
Open the Betaferon vial with the palm, or fleshy part, of your thumb.
Tip: It is not a good idea to use your fingernails because they may break.
Clean the top of the vial with the alcohol wipe, moving in one direction only.
Then place the alcohol wipe on top of the vial with the used side facing up.
Completely remove the cover from the vial adapter blister pack by holding the loose tag which is at the blue adapter end and peeling it back. Do not remove the vial adapter from the blister pack at this stage.
Tip: Make sure you keep the vial adapter sterile by not touching the vial adapter or the inside surface of the blister pack.
Before attaching the adapter remove and discard the alcohol wipe. Hold the blister pack on the outside and place it on top of the vial. Keep it sterile and push down firmly until the adapter snaps into place on the vial.
Tip: Always keep the vial on a flat surface (e.g. Betaferon injection mat, Betaferon Station) when attaching the adapter.
Keep hold of the blister pack, lift it away from the vial adapter and discard it. You are now ready to attach the prefilled diluent syringe.
Twist off the orange cap. As shows and remove it. The illustration shows someone holding the syringe in their right hand and pulling off the orange tip with the left hand, but you can also do it the other way around.
Tip: Make sure you only twist the orange cap. For a better grip, you may want to hold the transparent part with your other hand as shown in the illustration.
Now connect the syringe to the vial adapter. Carefully push the syringe in and twist it in a clockwise direction with a 3/4 turn – like using a screw driver. The syringe is now sealed onto the vial adapter. The syringe assembly is now complete and ready for dissolving the drug.
Tip: Do not overwind as the system is not designed for constant turning.
2. Dissolution
To dissolve the Betaferon powder, hold the syringe assembly by the bottom of the vial and slowly push the syringe plunger all the way in. This action transfers the solvent into the vial. Release the plunger without pulling it back. It may return to its original position on its own. This is OK.
Tip: Tilt the bottle slightly while you transfer the liquid.
It is important to completely dissolve the Betaferon powder now. The best way is to hold the assembly at the blue vial adapter and gently swirl it. This way you will avoid foaming.
Tip: Do not shake the vial because this could cause the solution to foam.
Examine the solution carefully. It should be clear and is ready for injection ONLY when it is transparent, colourless, and does not contain any particles. If the solution is discoloured or contains particles that cannot be dissolved with gentle swirling, discard it and start all over again.
Tip: If you see foam, let the vial stand until the foam settles down. It does not matter if a little bit of foam remains and you should not worry about it.
3. Preparing the injection
If the plunger has moved back towards its original position, push it in fully and hold it in place. Turn the assembly over so that the vial is on top. This position will allow the solution to flow into the syringe when you move the plunger. Proceed by drawing all the solution into the syringe. Pull back the plunger slowly. Keep the syringe in a horizontal position all the time.
Tip: Pulling the plunger back can cause some bubbles to form in the solution. This is OK. You’ll remove the bubbles in the next step. In general, the more slowly you retract the plunger, the fewer bubbles will form.
Turn the syringe assembly so that the needle is pointing straight up in the air. This brings all bubbles or foam to the top. Tap gently on the syringe. Push the excess air slowly back into the vial so that you end up with 1 ml of your Betaferon solution in the syringe, or the volume prescribed by your doctor.
Tip: If too much solution is expelled, return back to the previous horizontal position. Then pull the plunger back a little to redraw the solution until the correct dosage is reached. It is OK if it takes a couple of times. It will become easier with practice.
Return the syringe assembly to a horizontal position with the vial facing down. Remove the blue vial adapter from the syringe assembly by twisting it 1/4 turn to the left.
Separate both parts. Only after removal of the adapter the system will allow the solution to flow from the syringe into the needle! Your Betaferon is now ready for injection. You will learn how to inject yourself in the following chapters.
Delayed injection
If for some reason you must delay your injection, the solution must be placed in the refrigerator immediately. Do not place it in the freezer.
Your Betaferon dose can remain in the fridge for up to three hours. When you are then ready to inject, wash your hands again, take out your Betaferon from the refrigerator, and warm it up to body temperature by holding the sealed syringe in your hands for a while.
Do not heat it up in the oven, microwave or under hot running water! If more than three hours pass, you will have to discard the solution and start again.
