Guidance on self-injecting Nucala (mepolizumab)
Before you begin
Nucala is given as an injection under the skin once every four
weeks (every 28 days).
Your doctor, nurse, or pharmacist will decide whether you or your caregiver can inject Nucala at home,
and will provide training before you start.
Delivery
Make sure you are available to receive your Nucala delivery when it is due to arrive. Check that the box is labelled Nucala.
- Do not use Nucala before you or your caregiver has been trained to inject it.
- Store Nucala correctly. Keep the box containing Nucala in the fridge (2°C-8°C). Do not freeze. The unopened box may be stored at room temperature (up to 30°C) for up to 7 days, when protected from light. After this time, dispose of it safely (see Step 7 below). Keep this medicine out of the sight and reach of children.
Get to know your pre-filled Nucala pen
Preparation
If you have been advised that you can self-inject using the pre-filled pen, make sure you have the following items ready before each injection:
Nucala pre-filled pen
Alcohol swab
Cotton ball/gauze
Sharps disposal bin
Important: The pre-filled pen is for single use only. Dispose of it safely after use.
- Do not share your Nucala pre-filled pen with another person
- Do not shake the pen
- Do not use the pen if dropped onto a hard surface
- Do not use the pen if it appears damaged
- Do not remove the needle cap until just before your injection
- Do not use Nucala after the expiry date, which is shown on the label and carton after EXP
The importance of continuing your inhalers and other medication
It’s important to continue taking your existing COPD medications once you have started Nucala. Any changes to your treatment will be managed and supervised by your doctor, nurse, or pharmacist, so do not stop or change any of your medications unless they advise you to.
Injecting Nucala
Watch: Step-by-step guide
This video shows how to prepare and inject Nucala using the pre-filled pen, step by step.
It walks through each stage at a steady pace, so that you understand how and where to inject Nucala, and what you can expect during the process.
You should only inject Nucala after you or your caregiver has been trained by a healthcare professional. The video is designed to support your training and help you feel more confident injecting at home.
Read: Step-by-step guide
Whether you are injecting Nucala for the first time or the seventh, this guide provides clear, step-by-step instructions that you can read through at your own pace. You can refer back to it at any time, whenever you need a reminder.
- Take the box out of the fridge and check the security seals are not broken
- Remove the tray from the box and peel back the film cover from the tray
- Hold the middle of the pen and take it out of the tray carefully
- Place the pen on a clean, flat surface, at room temperature, away from direct sunlight
and
out of the reach of children
- Do not use the pen if the security seal on the carton is broken
- Do not remove the needle cap at this stage
- Check the expiry date on the label of the pen and do not use it if the date has passed
- Look in the inspection window to check that the liquid is clear (free from cloudiness or particles) and colourless to pale yellow to pale brown - it’s normal to see one or more air bubbles
- Wait 30 minutes (and no more
than 8 hours)
before use
- Do not use if the expiry date has passed
- Do not remove the needle cap during this step
- Do not use the pen if left out of the carton for more than 8 hours
- Do not warm the pen in a microwave, hot water, or direct sunlight
- Do not inject if the solution looks cloudy or discoloured, or has particles
- You can inject Nucala into your thighs or abdomen
- If someone else gives you the injection, they can also use your upper arm
- If you need more than one injection to complete your dose, then leave at least 5 cm
between each injection site
- Do not inject where your skin is bruised, tender, red, or hard
- Do not inject within 5 cm of your navel (belly button)
- Wash your hands with soap and water
- Clean your injection site by wiping the skin with an alcohol wipe and allowing the skin
to
air dry
- Do not touch your injection site again until you have finished your injection
- Remove the clear needle cap from the pen by firmly pulling it straight off
- Do not touch the yellow needle guard with your fingers. This could activate the pen too soon and may cause a needle injury
- After removal, do not put the needle cap back onto the pen, as it may accidentally start the injection
- Don’t worry if you see a drop of liquid at the end of the needle; this is normal
- Inject straight after removing the needle cap, and always within 5 minutes
- Hold the pen with its inspection window facing towards you, so you can see it, and with the yellow needle guard facing down
- Place the pen straight onto your injection site with the yellow needle guard flat against the surface of your skin, as shown
- To start the injection, push the pen down all the way and keep it held down against your skin. The yellow needle guard will slide up into the pen
- You should hear the 1st “click” to tell you your injection has started
- The yellow indicator will move down through the inspection window as you receive your
dose
- Do not lift the pen from your skin at this stage, as you might not get your full dose of medicine. Your injection may take up to 15 seconds to complete
- Do not use the pen if the yellow needle guard doesn’t slide up as described. Dispose of it (see Step 7), and start again with a new pen
- Keep the pen held down until you hear the 2nd “click”, and the stopper and yellow indicator have stopped moving and fill the inspection window
- Continue to hold the pen in place while you count
to 5. Then lift the pen away from your skin
- Check the inspection window is filled with the yellow indicator
- If you are not sure, hold the pen down for another 15 seconds to make sure the injection is complete
- Do not lift the pen until you’re sure the injection is complete
- You may notice a small drop of blood at the injection site. This is normal. Press a
cotton
wool ball or gauze on the area for a few moments if necessary
- Do not rub your injection site
- Dispose of the used pen and needle cap according to local requirements. If you need any advice, you can ask your doctor, nurse, or pharmacist
- Make sure that you keep used pens and needle caps out of the sight and reach of children
Missed dose guidance
If you miss taking a dose of Nucala, you or your caregiver can inject the missed one as soon as you remember. If it is already time for your next dose, skip the missed dose and take your next dose as planned. If you are unsure what to do, ask your doctor, nurse, or pharmacist.
Homecare support may be available if you are using Nucala at home.
Homecare support may be available if you are using Nucala at home. Your healthcare team can advise whether this support is available and appropriate for you.
This may include:
Delivery to your location of choice
Text reminder 24 hours before
2-hour delivery window
Two nurse training visits
Welcome call + welcome pack
Managing deliveries and storage information
Speak to your doctor, nurse, or pharmacist for details about availability and eligibility.
Download our patient booklet for practical information and helpful tracking tools
Guide to treatment
Our patient booklet includes a guide to self-injecting Nucala, and space to note down contact details for your healthcare team.
Injection tracker
Our patient booklet includes a handy dosing schedule where you can keep track of important information about your injections.
Notes section
Use our notes section to track how you are feeling, any questions for your doctor, nurse, or pharmacist, and any side effects.
