>> Hi, I'm Dr. Chelsea Campbell, a VA pharmacist,
and I want to discuss the medication Alirocumab with you and show you the proper way
to give yourself this medication.
I'll start with some general information about Alirocumab, what you should look
for after giving yourself the Alirocumab injection,
and then I'll show you how to self administer Alirocumab.
Let's get started.
Alirocumab is an injectable medication used to lower cholesterol in certain patients.
It is also used to lower the risk of another heart attack or a stroke in certain patients
who have already had one of these events.
Alirocumab is not for everyone with high cholesterol
or a history of heart attack or a stroke.
You and your provider, after discussing your healthcare needs and medication options,
decided that Alirocumab is necessary for managing your health conditions.
After injecting Alirocumab, you may experience mild side effects.
Common side effects of Alirocumab include injection site reactions, such as pain,
swelling, or redness at the site
where you injected the drug, or cold, or flu like symptoms.
Just like any medication, Alirocumab should not be used if you are allergic to it.
Severe allergic reactions may include hives, itching, difficulty breathing, rash,
or swelling of the face, lips, or tongue, which may require hospitalization
to treat if those side effects occur.
If you experience any severe allergic reactions to Alirocumab or the redness
at the injection site becomes serious to you, please stop its use
and contact your VA provider or pharmacist right away.
If you don't have the medication yet, this is what it will look like.
Alirocumab auto injectors come in two different doses; 75 milligram dose and 150 milligram dose.
If you need to give yourself a 300 milligram dose,
you will need two 150 milligram dose auto injectors as two separate injections.
The 75 milligram dose auto injector has a green activation button.
The 150 milligram dose auto injector has a gray activation button.
The dose of the 75 milligram, 150 milligram, or 300 milligrams,
and the schedule of every two weeks or every four weeks is determined
by your VA provider according to your healthcare needs.
The first step is to make sure that you read the prescription label
and match it with the dose on the package.
You should also inspect the package to make sure it was not damaged during mailing.
Be sure to refrigerate the medication immediately upon receiving it in the mail
or picking it up from your VA pharmacy.
Alirocumab can be stored at room temperature
up to 77 degrees Fahrenheit for no more than 30 days.
Alirocumab should be stored in its original container to protect it from light.
Remember to keep it out of reach of children and/or pets.
Before we discuss how to self inject Alirocumab,
let's first take a closer look at the medication.
This is called the Alirocumab auto injector, or prefilled pen.
It has several components.
The blue cap will need to be taken off just before you give yourself the injection.
The yellow safety cover has the needle hidden inside it.
Do not touch the yellow safety cover.
The medication window shows the medicine, which should be clear,
colorless to light yellow, and free from particles.
The medication window will change to a solid, bright yellow color
after you've injected the medication.
Your auto injector will either have a green or gray activation button.
This one has the gray colored button.
Don't touch it until you're ready to inject the medication.
There are several don'ts you need to remember when giving yourself the Alirocumab injection.
Don't use the auto injector after the expiration date on the label.
Don't shake the auto injector.
Don't remove the blue cap until you're ready to inject.
Don't use the auto injector if it has been dropped on a hard surface,
because there are parts inside that you cannot see that may break.
Don't use the auto injector if the window is bright yellow or if the medication seen
through the window is cloudy, discolored, or has visible flakes or particles.
If it is, call your VA provider or pharmacist about getting a replacement.
Gather all materials needed for your injection.
These materials include alcohol wipes, cotton balls, or gauze pads, adhesive bandages,
and the sharps disposal container.
If you don't have a sharps disposal container, use an empty liquid detergent bottle
and put a label on it that says used needles inside.
Ask your VA provider or pharmacist how to dispose
of the full sharps disposal container or liquid detergent bottle.
Next, remove the Alirocumab auto injector from the refrigerator.
Leave the medication at room temperature for at least 30
to 40 minutes before you plan to give the injection.
If you inject Alirocumab while it is still cold, you may experience unwanted side effects,
such as redness or pain at the injection site.
Do not try to warm the auto injector by placing it under running water or in the microwave.
Once the Alirocumab auto injector has reached room temperature,
it should not be put back in the refrigerator.
After you have collected the materials needed for your injection and allowed the auto injector
to come to room temperature, wash your hands with soap and water.
Next, choose an injection site.
The following areas of your skin are recommended for injection site.
Your thigh, your stomach area, at least two inches away from the area around your naval,
and the outer area of your upper arm.
If you choose to inject in your upper arm, you should have someone else give you the injection.
The Alirocumab auto injector has a very short needle, so the injection goes right
into the layer of fat just under your skin.
This is called a subcutaneous injection.
Wipe the injection site you choose with an alcohol swab and allow the skin to dry.
Now you are prepared to give yourself the Alirocumab injection.
When you are ready to inject, pull the blue cap straight off.
Do not put the blue cap back on.
Do not touch the yellow safety cover because the needle is hidden inside.
Make sure you can see the medication window.
With the blue cap off, put the yellow safety guard end straight
onto your bare skin that is at a 90 degree angle.
Do not touch the green or gray activation button yet.
Officially push the Alirocumab auto injector straight onto your bare skin
until the auto injector stops moving and the yellow safety cover is no longer visible.
The auto injector will not work if the yellow safety cover is not fully depressed.
If needed, pinch the skin to make sure the injection site is firm.
While maintaining firm pressure on the auto injector, click the green
or gray activation button with your thumb and then release the button.
The medication window will start to turn yellow.
Make sure to keep firm pressure on the auto injector against your bare skin
after releasing the green or gray activation button.
The injection may take up to 20 seconds.
Check that the medication window has turned completely yellow.
You may hear a second click.
Once the medication window is completely yellow, remove the auto injector from your bare skin.
If the medication window has not turned completely yellow,
that means you have not received the full dose and should call your VA provider or pharmacist.
After injecting, immediately discard the used Alirocumab auto injector and blue cap
into the sharps disposal container or empty liquid detergent bottle, as mentioned before.
Do not rub your skin after the injection.
If you see any blood, press a cotton ball or gauze pad
onto the site until the bleeding stops.
You are now done with the injection.
Of course, you want to watch for any side effects, including injection site reactions,
cold or flu like symptoms, or signs of an allergic reaction, such as hives, itching,
difficulty breathing, rash, or swelling of the face, lips, or tongue.
You will not be able to tell if the Alirocumab is working based on how you feel.
Your provider may order bloodwork in several months to check your cholesterol levels,
which will show if the Alirocumab is working.
You should also plan now for your next injection
since the medication is given every two weeks or every four weeks.
I recommend you mark your calendar or schedule a reminder on your phone
for the date of your next injection.
Don't forget to order your next refill so you have the medication
on hand when your next dose is due.
These are easy ways to ensure that you don't miss your next injection.
I thank you for your service to our country, and I'm honored to be of service to you on this day.