Re: Enbrel needle size

[Guest guest]

To everyone interested in the Enbrel needle size discussion:

When you open the Enbrel box that contains your Enbrel injections packs, you

will see a form that says " How to Use Enbrel " .

When you go to step 2, it specifically says use ONLY a 25 or 27 gauge needle.

It does not give the reason why, but it does stress this several times

throughout the " how to use " instructions. I was told at one point that

smaller needles will break down the proteins... but I really have no clue. I

just think it's best to stick with the size needles the manufacturer

suggests.... there must be a good reason, or they wouldn't specify a size. I

don't have the time to research it, but anyone who does... let me know what

you find. I do think it's HORRIBLE that the Enbrel nurses don't even know

that their own drug guidelines specify this.

[Ed. Note: The drug guidelines on Enbrel's own website do not specify needle

sizes. Ron]

[Guest guest]

In <102.24f7ed07.2b68a919@...>, on 01/28/03

at 10:48 PM, pookiegut@... said:

>I do think it's HORRIBLE that the Enbrel nurses don't even know that

>their own drug guidelines specify this.

It's probably worth an E-mail to them.

--

-----------------------------------------------------------

" Mark Abramowitz " <marka@...>

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[Guest guest]

In a message dated 1/29/03 3:12:23 AM Eastern Standard Time,

pookiegut@... writes:

> Ed. Note: The drug guidelines on Enbrel's own website do not specify needle

> sizes. Ron]

>

>

Ron,

I realize this... although I have not had the time to search the website

myself. Would someone please look at their package insert of the Enbrel box,

go to Step 2 on the " How to Use " Instructions, and agree with me that it says

ONLY use 25 or 27 gauge needles? It says it 3 times during reading of the

insert. Will someone PLEASE agree that it is there, so I won't look like I am

just trying to make someone look wrong. I DID NOT just make this up for the

fun of making someone else look dumb. Anyone who has had a Dr. give them

needles that are not 25 or 27 gauge... please take the insert to your Dr. and

show him/her where it says that. They need to talk to their Enbrel

salesman/woman as to why this is a specification. I can't tell you how many

things I have learned by reading package inserts, and have taken it to my

Dr... and in turn they learned something. I have even found out about drugs

that work against each other by reading... and taken it to my Dr. The few

times I have done this they have called the pharmacy and the supplier and

every time they have removed me from one or both meds. (One example was a

certain birth control - Apri to be exact - and Celebrex that should not be

taken together. Reading the Celebrex insert told me that these 2 drugs should

not be mixed, because they can cause an elevation in Potassium that can cause

heart issues. I called my OBGYN, and she said " Oh goodness, I didn't know

that. " She called the manufacturers and spoke to a Pharmacist (who also

didn't know this... but also called the manufacturers... and they immediately

removed me from this specific birth control.) It is SO SCARY how little Dr.'s

know about these new drugs on the market, but many of them learn what they

know from the pharmaceutical sells rep... so if the rep is not doing a great

job teaching, or if the Dr. does not listen well, things get missed and

important specs can be forgotten/dismissed.

So, please take the Enbrel insert to your Dr. if you are using a different

size needle than what is recommended. Have them call their rep and research

why it specified this. Go in with the sentences that specifically state the

needle size highlighted, so you don't waste time fumbling, and leave the

sheet with the Dr. so he/she has something to reference when they do their

research. It is doubtful they will go pull a sheet and highlight it on their

own, so if you hand it to them they have no excuse.

___________________________________________________________

Ed. Note: I too would like to get to the bottom of this. Below is Step 2 of the

" Instructions For Preparing And Giving An Injection " package insert from the

Immunex Corporation's own Enbrel website. The page is located at

http://www.enbrel.com/hcp/about_enbrel/dosing.jsp and the PDF document is at

http://www.enbrel.com/hcp/pdf_files/dosing_n_administration.pdf

-- Ron

---------------- Begin Quote -------------------

How to Use ENBREL (etanercept)

INSTRUCTIONS FOR PREPARING AND GIVING AN INJECTION

Step 2:

Choosing and preparing an injection site

1. Choose an injection site on the thigh, stomach, or the back part of

the upper arm.

2. Rotate sites with each new injection. Make sure that the new injection

is given at least one inch from an old site. Do not inject into areas

where the skin is tender, bruised, red, or hard. (It may be helpful to

keep notes on the location of the previous injections.)

3. To prepare the area of skin where ENBREL is to be injected, wipe the

injection site well with an alcohol swab, using a circular motion. DO

NOT touch this area again before giving the injection.

[Guest guest]

,

You are right and that is way, if you damage the needle that comes with the

Enbrel you are to open and use another needle and report the damaged one to

the company so that they can give you a replacement. YOU ARE NOT TO GET

NEEDLES other than from the manufacturer or your doctor as I understand it as

a professional and from the company.

[Guest guest]

Hi Ron,

This is not the same insert that comes with the package. There are 2 inserts

that come with the box of Enbrel. One is the rundown of the drug that all

pharmacists give you, and the other is similar to what you have below... but

more extensive. This prints on 2 pages, whereas the insert in the box would use

4 or 5 pages to print. I just don't get it... and they are BOTH from the same

company.. go figure. I still encourage anyone taking this to show their Dr. this

in the package insert... if for no other reason than to make the Dr. aware that

it does list needle gauge restrictions. An Enbrel nurse should really be able to

answer this question, but if they are using the same " How to " guide listed

below, then I don't know how they could know the " right " answer to this!

How frustrating!

In a message dated 1/29/2003 11:20:44 PM Eastern Standard Time, pookiegut

writes:

> Ed. Note: I too would like to get to the bottom of this. Below is Step 2 of

the " Instructions For Preparing And Giving An Injection " package insert from the

Immunex Corporation's

> own Enbrel website. The page is located at

[Guest guest]

Update on the needle size issue:

On the insert that comes with the Enbrel meds, it says " The

supplied syringe and 25 gauge needle should be used only

once. Contact your/your child's doctor or healthcare provider to

obtain additional syringes (1 mL) and needles (25 or 27 gauge). "

I called the Enbrel # on the insert (1-888-436-2735) and read the

nurse the above quote asked her if the 27 gauge was a limit for

how small a needle we could use because my doctor gave me

30 gauge needles. She said that the needle size was up to the

discretion of my doctor, that if my doctor thought 30 gauge was

fine then it's fine, she had no limits specified by Enbrel. She

said the needle that comes with the meds is 25 gauge and

insulin needles are usually 27 gauge, which is probably why the

insert specified those two sizes.

Hope this helps clear up some confusion.