How to give yourself a Rebif injection

Rebif is a popular disease modifying drug used to treat remitting – relapsing multiple sclerosis.  It is injected sub-cutaneously (into the fat layer just beneath the skin) three times a week.

I had mixed feelings when I started on Rebif.  On the one hand, I was not at all enthusiastic about giving myself shots.  On the other hand, I felt like I was finally doing something to treat my condition.

For people who may be considering Rebif treatment, I thought that I would share what exactly is involved with taking the medication.

First of all, It’s really not that bad.  Really.  It only takes a few minutes, three times a week and you quickly get used to it.  When you first start, MS Lifelines, aka the pharmaceutical company, sends out a nurse to your home to coach you on how to do the injections.  You will rotate injection sites between your abdomen, thigh, upper arm and lower back/buttocks.  Within each of these you will also rotate between six spots on both the left and right sides each for a total of 48 injection spots.  At three times a week, you will go four months before repeating specific locations.

The first two weeks you will do a dose that is approximately a fifth of the full dose.  The following two weeks you will move up to half doses before taking on the full doses starting in the fifth week.  It’s helpful to pull out the pre-filled syringe out of the refrigerator several hours in advance to allow it to warm up to room temperature.  Supposedly this reduces injection site reactions.  I haven’t had any so it probably does help.  The syringes can be kept at room temperature for up to 30 days.  Some people take out a week’s worth at a time.  I just always keep the next dose in my sock drawer.  When I inject one, I pull another out of the fridge to replace it.

Step one:  Wipe the site with an alcohol wipe and let dry.

Step two:  I use the Rebiject injection tool.  It’s about the size of a large banana and if you fear needles, it’s a must.  You never see the needle until after you are all done.  Cock the spring loading mechanism in the Rebiject.  Insert the pre-filled syringe with the cap still on it into the hole and screw the two pieces of the Rebiject together.  Pull off the plastic tube on the end which removes the syringe cap and you are ready to go.

Step three:  Press the end of the tool against the chosen injection site and push the button.  The tool sticks the syringe into you and squeezes out the dose without you ever seeing it.  Wait a few seconds and pull away the Rebiject.

Step four:  Massage the injection site for two minutes to help distribute the medication.  I put a sterile gauze pad over it and rub gently, but you could use your hand if it is clean.

Step five:  Unscrew the Rebiject and dispose of the needle in your sharps container.  They give you two containers with a prepaid addressed box to send a full one back.  When you do, they send you a replacement.

When you first start, a common side effect is flu like symptoms.  They recommend that you take advil before your dose and shoot up at night.  That way if you do suffer the flu symptoms, you will likely sleep through it.

I was lucky and did not have flu symptoms or issues at the injection sites.  I did, however, have a different and less common side effect.  That will be the subject for the next post.

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