Novarel Trigger Patient Instructions

Human Chorionic Gonadotropin- Subcutaneous Injection (10,000 IU Novarel, HCG)

Storage: Store at room temperature until reconstituted- following reconstitution, solution is stable when refrigerated.

Supplies: 3 mL syringe to mix and inject HCG Trigger, 22 gauge 1½ inch needle to mix HCG Trigger, 27 gauge ½ inch needle to inject HCG Trigger, alcohol swabs.

Instructions

1. Wash your hands and work on a clean, dry surface.
2. You will use two boxes of Novarel for your trigger injection. You will use both vials of powder. However, you will only need to use 1 mL vial of bacteriostatic water.
3. Attach a 22 gauge 1 ½ inch needle to a 3 mL syringe.
4. Remove the protective caps from all vials. Clean the tops of all vials with an alcohol swab.
5. Pull back on the plunger to draw up 1 mL air into the syringe.
6. Turn the vial upside down with the needle still in the vial. Adjust the needle so that the tip of the needle is in the water, not the air space. Slowly pull back on the plunger to draw up 1 mL of bacteriostatic water. If there is air in the syringe, push the liquid back into the vial and withdraw again. You only need to worry about air bubbles that extend from one side of the syringe to the other- any other bubble smaller than that is nothing to worry about.
7. Remove the needle from the vial of bacteriostatic water. You are only using 1 mL, so there will be a large amount left in the vial. You will not need this extra bacteriostatic water left in the vial, it can be discarded now.
8. Inject the 1 mL bacteriostatic water in the syringe into the first vial of Novarel powder.
9. Swirl the vial gently until all of the powder is dissolved.
10. You will now draw up all of the mixed medication in the vial: turn the bottle upside down with the needle still in it. Again, adjust the needle depth in the vial until the tip of the needle is in the liquid and not the air space. Start drawing up medication by pulling back on the plunger. You may need to adjust the needle tip a few times so that you can draw up all of the medication in the vial.
11. Now inject the medication in your syringe into the second vial of powder and gently swirl vial until all the powder is dissolved. Draw all of the medication out of this vial.
12. Check that you have drawn up all of the medication from both medication vials:
    1. There should be 1 mL medication in your syringe.
    2. There should not be anything left in either of the vials of Novarel (a tiny amount of medication is OK).

Administration

1. Choose an injection site on your abdomen (see image).
2. Take the 1 ½ inch needle off the syringe and put on the ½ inch needle.
3. Clean the area with an alcohol swab and allow to dry.
4. Pinch up the skin.
5. Insert the needle straight into the skin- do not go in at an angle.
6. Push the plunger all the way down, then wait 2-3 seconds before removing the needle from the skin.