Tips & Troubleshooting

Tips & Troubleshooting

Tips for injecting ELIGARD

Set expectations with your patient while mixing ELIGARD.

ELIGARD must be mixed for 45 seconds, so this is a great time to let the patient know what to expect. For example, you can tell them:

  • There is no interruption in their treatment
  • This treatment is injected into subcutaneous fat instead of muscle
  • They might experience some injection site burning and stinging. About 20% of patients feel this, it’s to be expected and should be transient.
  • No muscle tenderness that would occur with needle trauma following an intramuscular injection.

  • Room temperature

    If it’s cold, ELIGARD will be more difficult to mix and might not reconstitute properly. It must be room temperature before mixing.

    Though ELIGARD is shipped refrigerated, it can be stored for up to 8 weeks at room temperature — it can be stocked on shelves in order to be ready for mixing and injection.

  • 45 seconds of mixing

    ELIGARD must be mixed for 45 seconds in order for it to be ready to correctly administer the treatment.

  • 90° angle

    ELIGARD comes with a shorter 5/8 inch needle for injecting. Therefore, always inject at a simple 90° angle (no need to calculate angle to the skin).

  • Less than 30 minutes

    ELIGARD should be administered as soon as possible after mixing. After 30 minutes the polymer becomes thick, making administering the treatment ineffective. To ensure the patient receives the correct treatment, do not wait more than 30 minutes after mixing to administer.

Troubleshooting

If ELIGARD is very difficult to mix and/or administer

Possibility 1 – Blue plunger rod not removed correctly

The blue plunger rod from Syringe B must be popped out, not screwed out. When screwed out, sometimes the gray stopper that should be attached remains behind in the tube. Mixing and administering is extremely difficult with two (2) gray stoppers in the tube.

Pull the blue plunger rod straight out — you’ll hear a pop, and you’ll see the gray ‘hat’ on the blue plunger rod. When that gray ‘hat’ is left in the syringe, the mixing procedure can be difficult.

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Wrong: blue cap was screwed off, leaving the gray stopper inside Syringe B

Possibility 2 – More than 30 minutes

After 30 minutes, the polymer becomes viscous, making mixing and injecting very difficult.

Administer ELIGARD as soon as possible after opening and mixing. Administer within 30 minutes.

Possibility 3 – Product is too cold

ELIGARD needs to be brought to room temperature before mixing and administering.

ELIGARD can be stocked at room temperature for up to eight (8) weeks – it does not need to be kept in cold storage unless it will not be used for 8 weeks.

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ELIGARD must be room temperature, and administered within 30 minutes of mixing
Contact us

Have you followed all the steps, but still have difficult mixing and/or administering ELIGARD? Please contact our medical team:

If the patient says the injection of ELIGARD hurts

Possibility 1 – Injection not performed at 90° angle

ELIGARD has a short needle designed to be used at a 90° angle to the injection site. Injecting at a different angle may cause the product to be injected in a shallow site with more nerve endings, causing the patient pain. Always inject ELIGARD at 90°.

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ELIGARD should be injected at a 90° angle into an appropriate subcutaneous region

Possibility 2 – Needle is pulled out before all product is dispensed

Inject ELIGARD slowly until the gray stopper goes all the way down to the hub. Only then should you pull the needle out, to avoid product in shallower, more sensitive layers of the dermis.

Would you like a mixing & administration demo?

Send us an in-service (demo) request. We can meet in person or via the platform of your choice.

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IMPORTANT SAFETY INFORMATION

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ELIGARD®, (leuprolide acetate) for injectable suspension, is indicated for the palliative treatment of advanced prostate cancer.

ELIGARD is contraindicated in patients with hypersensitivity to GnRH, GnRH agonists, or any of the components of ELIGARD. Anaphylactic reactions to synthetic GnRH or GnRH agonists have been reported in the literature. Transient increase in serum levels of testosterone during treatment may result in worsening of symptoms or onset of new signs and symptoms during the first few weeks of treatment, including bone pain, neuropathy, hematuria, bladder outlet obstruction, ureteral obstruction, or spinal cord compression. Monitor patients at risk closely and manage as appropriate.

Hyperglycemia and an increased risk of developing diabetes have been reported in men receiving GnRH agonists. Monitor blood glucose level and manage according to current clinical practice. Increased risk of myocardial infarction, sudden cardiac death and stroke has also been reported with use of GnRH agonists in men. Monitor for cardiovascular disease and manage according to current clinical practice. Androgen deprivation therapy may prolong the QT/QTc interval. Consider risks and benefits. May cause fetal harm. Convulsions have been observed in patients taking leuprolide acetate with or without a history of predisposing factors. Manage convulsions according to current clinical practice.

ELIGARD may impair fertility in males of reproductive potential.

The most common injection site adverse events are transient burning and stinging, pain, bruising, and erythema. The most common systemic adverse events include mild to severe hot flashes/sweats, malaise and fatigue, weakness, myalgia, dizziness, clamminess, testicular atrophy, and gynecomastia. As with other GnRH agonists, other adverse reactions, including decreased bone density and rare cases of pituitary apoplexy have been reported.

See package insert for full prescribing and safety information.

Please see full Prescribing Information for ELIGARD and full Prescribing Information for ELIGARD with Pre-connected Syringe System.