Instructions for inclusion on the instruction card as applicable: The following information is intended for medical or healthcare professionals only: ZOLADEX is administered by subcutaneous injection - read and understand all the instructions fully prior to administration.
1. Put the patient in a comfortable position with the upper part of the body slightly raised. Prepare the injection site according to the local policy and procedure.
NOTE: Caution should be taken while injecting ZOLADEX into the anterior abdominal wall due to the proximity of underlying inferior epigastric artery and its branches; very thin patients may be at higher risk of vascular injury.
2. Examine the foil pouch and syringe for damage. Remove the syringe from the opened foil pouch and hold the syringe at a slight angle to the light.
Check that at least part of the ZOLADEX implant is visible.
3. Grasp the plastic safety tab and pull away from the syringe, and discard. Remove needle cover. Unlike liquid injections, there is no need to remove air bubbles as attempts to do so may displace the ZOLADEX implant.
4. Holding the syringe around the protective sleeve, using an aseptic technique, pinch the patient's skin and insert the needle at a slight angle (30 to 45 degrees) to the skin.
With the opening of the needle facing up, insert needle into the subcutaneous tissue of the anterior abdominal wall below the navel line, until the protective sleeve touches the patient's skin.
NOTE: The ZOLADEX syringe cannot be used for aspiration. If the hypodermic needle penetrates a large vessel, blood will be seen instantly in the syringe chamber. If a vessel is penetrated, withdraw the needle and immediately control any resultant bleeding, monitoring the patient for signs or symptoms of abdominal haemorrhage. After ensuring the patient is haemodynamically stable another ZOLADEX implant may be injected with a new syringe elsewhere. Use extra care when administering ZOLADEX to patients with a low BMI and/or to patients receiving full dose anticoagulation.
5. Do not penetrate into muscle or peritoneum.
6. Depress the plunger fully, until you can depress no more, to discharge the ZOLADEX implant and to activate the protective sleeve. You may hear a 'click' and will feel the protective sleeve automatically begin to slide to cover the needle. If the plunger is not depressed fully, the protective sleeve will NOT activate.
NOTE: The needle does not retract.
7. Holding the syringe, withdraw the needle and allow protective sleeve to continue to slide and cover needle.
Dispose of the syringe in an approved sharps collector.
NOTE: In the unlikely event of the need to surgically remove a ZOLADEX implant, it may be localized by ultrasound.