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• Grasp one liquid (diluent) ampule with your thumbs near the neck of the ampule and break open the ampule with a quick snap away form you (make sure that the dot on the liquid ampule is facing away from you). Always use gauze or tissue when opening glass ampules to prevent the possibility of getting cut.
note that some medications e.g. repronex will not come in an ampule container
• Repeat this process with the number of powder ampules of gonadotropins needed for your injection
• Withdraw 0.5cc (1/2 cc) of diluent from the ampule using a 1 cc syringe with a 22 gauge needle.
• Insert the needle into the ampule of powder and slowly inject the 0.5cc of liquid into it.
• Withdraw all of the dissolved medication back into the syringe.
• Check for air bubbles in syringe. Tap syringe with finger to move the air bubbles up to top of syringe. Pull back on the plunger before pushing up to remove air (be careful not to expel medication)
• Carefully recap needle until injection is given.
• NOTE: If the dose is more than one ampule, add the solution you have just drawn up to the next powder ampule, then draw it up back into the syringe. This process can be repeated until the required amount of powder ampules have been mixed. You will notice that the original volume of liquid used (0.5cc) will increase as more powder is mixed into it.
• Draw up the medication as above. Change the needle from the larger 22 gaugue to the smaller 27 gauge.
• Select site (see diagram) for injection. Consider alternating the injection site daily.
• Clean injection site with alcohol wipe from inside to outside, then let dry.
• Pinch up skin and insert needle quickly and firmly at a 45-90d degree angle.
• Inject the medication slowly and smoothly.
• Remove the needle. Briefly massage with alcohol to increase the absorption.
• Apply direct pressure to injection site for 4-5 seconds.
Profasi (HCG) injections are prepared in the same way except 1cc of diluent is used. The 1cc of mixed solution should be split in half by giving 0.5cc is one location and the other 0.5cc in a different locationusing the same syringe.
Repronex (FSH with LH) is prepared the same way as Gonal-F
Antagon and Lupron comes already premixed in an ampule. Premixing is therefore not needed. Use the whole ampule content for injection.
