PLEGRIDY is indicated for the treatment of relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.

{ "type": "p", "children": [], "text": "PLEGRIDY is indicated for the treatment of relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.\n" }

PLEGRIDY may only be administered subcutaneously (SC) or intramuscularly (IM).

Recommended Maintenance Dosage

After initial titration (see Table 1 and Table 2), the recommended dosage of PLEGRIDY is 125 micrograms injected every 14 days.

For subcutaneous injection:

Patients may rotate injection sites between the abdomen, back of the upper arm, or thigh.

For intramuscular injection:

Patients may rotate injection sites between the left and right thighs.

Treatment Initiation

Dose titration at the initiation of treatment may help to ameliorate flu-like symptoms that can occur at treatment initiation with interferons. Prophylactic and concurrent use of analgesics and/or antipyretics may prevent or ameliorate flu-like symptoms sometimes experienced during treatment with PLEGRIDY.

Switching between the subcutaneous and intramuscular routes of administration and vice versa has not been studied. It is not expected that dose titration should be repeated to ameliorate flu-like symptoms if switching between subcutaneous and intramuscular routes of administration, or vice versa based upon bioequivalence demonstrated between the two routes of administration.

Subcutaneous Administration of PLEGRIDY

Patients using PLEGRIDY for the first time should start treatment with 63 micrograms on day 1. On day 15 (14 days later), the dose is increased to 94 micrograms, reaching the full dose of 125 micrograms on day 29 (after another 14 days). Patients continue with the full dose (125 micrograms) every 14 days thereafter (see Table 1). A PLEGRIDY Starter Pack is available containing two prefilled pens or syringes: 63 micrograms (dose 1) and 94 micrograms (dose 2).

<div class="scrollingtable"><table width="100%"> <caption> <span>Table 1: Schedule for Subcutaneous Dose Titration </span> </caption> <col align="left" width="17.971%"/> <col align="left" width="27.343%"/> <col align="left" width="27.343%"/> <col align="left" width="27.343%"/> <thead> <tr class="First Last"> <th align="center" class="Botrule Lrule Rrule Toprule" valign="top"><span class="Bold">Dose</span></th><th align="center" class="Botrule Rrule Toprule" valign="top"><span class="Bold">Time</span><span class="Bold"><span class="Sup">a</span></span></th><th align="center" class="Botrule Rrule Toprule" valign="top"><span class="Bold">Amount (micrograms)</span></th><th align="center" class="Botrule Rrule Toprule" valign="top"><span class="Bold">Color of Pen or</span> <br/> <span class="Bold">Syringe Label</span></th> </tr> </thead> <tfoot> <tr class="First Last"> <td align="left" colspan="4" valign="top"> <p class="First Footnote"> <span class="Sup">a</span> Dosed every 14 days </p> </td> </tr> </tfoot> <tbody> <tr class="First"> <td align="center" class="Botrule Lrule Rrule" valign="top">Dose 1 </td><td align="center" class="Botrule Rrule" valign="top">On day 1 </td><td align="center" class="Botrule Rrule" valign="top">63 </td><td align="center" class="Botrule Rrule" valign="top">Orange </td> </tr> <tr> <td align="center" class="Botrule Lrule Rrule" valign="top">Dose 2 </td><td align="center" class="Botrule Rrule" valign="top">On day 15 </td><td align="center" class="Botrule Rrule" valign="top">94 </td><td align="center" class="Botrule Rrule" valign="top">Blue </td> </tr> <tr class="Last"> <td align="center" class="Botrule Lrule Rrule" valign="top">Dose 3 </td><td align="center" class="Botrule Rrule" valign="top">On day 29 and every 14 days thereafter </td><td align="center" class="Botrule Rrule" valign="top">125 (full dose) </td><td align="center" class="Botrule Rrule" valign="top">Grey </td> </tr> </tbody> </table></div>

Intramuscular Administration of PLEGRIDY

For patients using PLEGRIDY injected intramuscularly for the first time, PLEGRIDY should be titrated using the PLEGRIDY Titration Kit designed for use with the prefilled syringe. The PLEGRIDY Titration Kit is supplied separately and contains two titration devices to be used only with PLEGRIDY prefilled syringes for intramuscular use.

Patients should start treatment with 63 micrograms (yellow clip) on day 1. On day 15 (14 days later), the dose is increased to 94 micrograms (purple clip), reaching the full dose of 125 micrograms on day 29 (after another 14 days). Patients continue with the full dose (125 micrograms) every 14 days thereafter (see Table 2).

<div class="scrollingtable"><table width="100%"> <caption> <span>Table 2: Schedule for Intramuscular Dose Titration </span> </caption> <col align="left" width="17.971%"/> <col align="left" width="27.343%"/> <col align="left" width="27.343%"/> <col align="left" width="27.343%"/> <thead> <tr class="First Last"> <th align="center" class="Botrule Lrule Rrule Toprule" valign="top"><span class="Bold">Dose</span></th><th align="center" class="Botrule Rrule Toprule" valign="top"><span class="Bold">Time</span><span class="Bold"><span class="Sup">a</span></span></th><th align="center" class="Botrule Rrule Toprule" valign="top"><span class="Bold">Amount (micrograms)</span></th><th align="center" class="Botrule Rrule Toprule" valign="top"><span class="Bold">Titration Clip</span></th> </tr> </thead> <tfoot> <tr class="First Last"> <td align="left" colspan="4" valign="top"> <p class="First Footnote"> <span class="Sup">a</span> Dosed every 14 days </p> </td> </tr> </tfoot> <tbody> <tr class="First"> <td align="center" class="Botrule Lrule Rrule" valign="top"> Dose 1 </td><td align="center" class="Botrule Rrule" valign="top">On day 1 </td><td align="center" class="Botrule Rrule" valign="top">63 </td><td align="center" class="Botrule Rrule" valign="top">Yellow </td> </tr> <tr> <td align="center" class="Botrule Lrule Rrule" valign="top"> Dose 2 </td><td align="center" class="Botrule Rrule" valign="top">On day 15 </td><td align="center" class="Botrule Rrule" valign="top">94 </td><td align="center" class="Botrule Rrule" valign="top">Purple </td> </tr> <tr class="Last"> <td align="center" class="Botrule Lrule Rrule" valign="top"> Dose 3 </td><td align="center" class="Botrule Rrule" valign="top">On day 29 and every 14 days thereafter </td><td align="center" class="Botrule Rrule" valign="top">125 (full dose) </td><td align="center" class="Botrule Rrule" valign="top">No Clips Needed </td> </tr> </tbody> </table></div>

Healthcare professionals should train patients in the proper technique for self-administering subcutaneous injections using the prefilled pen or syringe or intramuscular injections using the prefilled syringe. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. Advise patients and caregivers to rotate injection sites with each administration to minimize the likelihood of severe injection site reactions, including necrosis or localized infection [see Warnings and Precautions (5.4)].

Once removed from the refrigerator, PLEGRIDY should be allowed to warm to room temperature (about 30 minutes) prior to injection. Do not use external heat sources such as hot water to warm PLEGRIDY.

Each PLEGRIDY pen and syringe for subcutaneous injection is provided with the needle pre-attached. PLEGRIDY prefilled syringe for intramuscular injection is supplied as a prefilled syringe with a separate needle. Both intramuscular and subcutaneous prefilled syringes and subcutaneously administered prefilled pens are for one-time use in one patient only and should be discarded after use.

Prophylactic and concurrent use of analgesics and/or antipyretics may prevent or ameliorate flu-like symptoms sometimes experienced during treatment with PLEGRIDY.

Subcutaneous Administration:

Intramuscular Administration:

PLEGRIDY is contraindicated in patients with a history of hypersensitivity to natural or recombinant interferon beta or peginterferon, or any other component of PLEGRIDY [see Warnings and Precautions (5.3)].

{ "type": "p", "children": [], "text": "PLEGRIDY is contraindicated in patients with a history of hypersensitivity to natural or recombinant interferon beta or peginterferon, or any other component of PLEGRIDY [see Warnings and Precautions (5.3)].\n" }

Severe hepatic injury, including hepatitis, autoimmune hepatitis, and rare cases of severe hepatic failure, have been reported with interferon beta. Asymptomatic elevation of hepatic transaminases has also been reported, and in some patients has recurred upon rechallenge with interferon beta.

Elevations in hepatic enzymes and hepatic injury have been observed with the use of PLEGRIDY in clinical studies. The incidence of increases in hepatic transaminases was greater in patients taking PLEGRIDY than in those taking placebo. The incidence of elevations of alanine aminotransferase above 5 times the upper limit of normal was 1% in placebo-treated patients and 2% in PLEGRIDY-treated patients. The incidence of elevations of aspartate aminotransferase above 5 times the upper limit of normal was less than 1% in placebo-treated patients and less than 1% in PLEGRIDY-treated patients. Elevations of serum hepatic transaminases combined with elevated bilirubin occurred in 2 patients. Both cases resolved following discontinuation of PLEGRIDY.

Cases of noninfectious hepatitis have been reported in the postmarketing setting with use of PLEGRIDY.

Monitor patients for signs and symptoms of hepatic injury.

Depression, suicidal ideation, and suicide occur more frequently in patients receiving interferon beta than in patients receiving placebo.

In clinical studies, the overall incidence of adverse events related to depression and suicidal ideation in multiple sclerosis patients was 8% in both the PLEGRIDY and placebo groups. The incidence of serious events related to depression and suicidal ideation was similar and less than 1% in both groups.

Advise patients to report immediately any symptom of depression or suicidal ideation to their healthcare provider. If a patient develops depression or other severe psychiatric symptoms, consider stopping treatment with PLEGRIDY.

Serious allergic reactions are rare complications of treatment with interferon beta; anaphylaxis has been reported with use of PLEGRIDY in the postmarketing setting.

Less than 1% of PLEGRIDY-treated patients experienced a serious allergic reaction such as angioedema or urticaria. Those who did have serious allergic reactions recovered promptly after treatment with antihistamines or corticosteroids. Discontinue PLEGRIDY if a serious allergic reaction occurs.

The protective rubber cover of the PLEGRIDY prefilled syringe for intramuscular administration contains natural rubber latex which may cause allergic reactions and should not be handled by latex-sensitive individuals. The safe use of PLEGRIDY prefilled syringe in latex-sensitive individuals has not been studied.

Injection site reactions, including injection site necrosis, can occur with the use of interferon beta, including PLEGRIDY.

In clinical studies of subcutaneous PLEGRIDY, the incidence of injection site reactions (e.g., injection site erythema, pain, pruritus, or edema) was 66% in the PLEGRIDY group and 11% in the placebo group; the incidence of severe injection site reactions was 3% in the PLEGRIDY group and 0% in the placebo group. One patient out of 1468 patients who received PLEGRIDY in clinical studies experienced injection site necrosis. The injury resolved with standard medical treatment.

In Study 3, which compared single doses of intramuscular and subcutaneous PLEGRIDY [see Adverse Reactions (6.1)], the incidence of injection site reactions (e.g., injection site erythema, pain, pruritus, or edema) was 14% in the intramuscular PLEGRIDY group and 32% in the subcutaneous PLEGRIDY group.

Injection site abscesses and cellulitis have been reported in the postmarketing setting with use of interferon beta. Some cases required treatment with hospitalization for surgical drainage and intravenous antibiotics.

Periodically evaluate patient understanding and use of aseptic self-injection techniques and procedures, particularly if injection site necrosis has occurred.

Decisions to discontinue therapy following necrosis at a single injection site should be based on the extent of the necrosis. For patients who continue therapy with PLEGRIDY after injection site necrosis has occurred, avoid administration of PLEGRIDY near the affected area until it is fully healed. If multiple lesions occur, change injection site or discontinue PLEGRIDY until healing occurs.

Congestive heart failure, cardiomyopathy, and cardiomyopathy with congestive heart failure occur in patients receiving interferon beta.

In clinical studies, the incidence of cardiovascular events was 7% in both PLEGRIDY and placebo treatment groups. No serious cardiovascular events were reported in the PLEGRIDY group.

Monitor patients with significant cardiac disease for worsening of their cardiac condition during initiation and continuation of treatment with PLEGRIDY.

Interferon beta can cause decreased peripheral blood counts in all cell lines, including rare instances of pancytopenia and severe thrombocytopenia.

In clinical studies, decreases in white blood cell counts below 3.0 x 109/L occurred in 7% of patients receiving PLEGRIDY and in 1% receiving placebo. There is no apparent association between decreases in white blood cell counts and an increased risk of infections or serious infections. The incidence of clinically significant decreases in lymphocyte counts (below 0.5 x 109/L), neutrophil counts (below 1.0 x 109/L), and platelet counts (below 100 x 109/L) were all less than 1% and similar in both placebo and PLEGRIDY groups. Two serious cases were reported in patients treated with PLEGRIDY: one patient (less than 1%) experienced severe thrombocytopenia (defined as a platelet count less than or equal to 10 x 109/L), and another patient (less than 1%) experienced severe neutropenia (defined as a neutrophil count less than or equal to 0.5 x 109/L). In both patients, cell counts recovered after discontinuation of PLEGRIDY. Compared to placebo, there were no significant differences in red blood cell counts in patients treated with PLEGRIDY.

Monitor patients for infections, bleeding, and symptoms of anemia. Monitor complete blood cell counts, differential white blood cell counts, and platelet counts during treatment with PLEGRIDY. Patients with myelosuppression may require more intensive monitoring of blood cell counts.

Cases of thrombotic microangiopathy (TMA), including thrombotic thrombocytopenic purpura and hemolytic uremic syndrome, some fatal, have been reported with interferon beta products. Cases have been reported several weeks to years after starting interferon beta products. Discontinue PLEGRIDY if clinical symptoms and laboratory findings consistent with TMA occur, and manage as clinically indicated.

Cases of pulmonary arterial hypertension (PAH) have been reported in patients treated with interferon beta products, including PLEGRIDY. PAH has occurred in patients treated with interferon beta products in the absence of other contributory factors. Many of the reported cases required hospitalization, including one case with interferon beta in which the patient underwent a lung transplant. PAH has developed at various time points after initiating therapy with interferon beta products and may occur several years after starting treatment.

Patients who develop unexplained symptoms (e.g., dyspnea, new or increasing fatigue) should be assessed for PAH. If alternative etiologies have been ruled out and a diagnosis of PAH is confirmed, discontinue treatment and manage as clinically indicated.

Autoimmune disorders of multiple target organs including idiopathic thrombocytopenia, hyper- and hypothyroidism, and autoimmune hepatitis have been reported with interferon beta.

In clinical studies, the incidence of autoimmune disorders was less than 1% in both PLEGRIDY and placebo treatment groups.

If patients develop a new autoimmune disorder, consider stopping PLEGRIDY.

Seizures are associated with the use of interferon beta.

The incidence of seizures in multiple sclerosis clinical studies was less than 1% in patients receiving PLEGRIDY and placebo.

Exercise caution when administering PLEGRIDY to patients with a seizure disorder.

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of PLEGRIDY cannot be directly compared to rates in clinical trials of other drugs and may not reflect the rates observed in practice.

PLEGRIDY Via Subcutaneous Administration

In clinical studies (Study 1 and Study 2), a total of 1468 patients with relapsing multiple sclerosis received PLEGRIDY by subcutaneous injection for up to 177 weeks (41 months), with an overall exposure equivalent to 1932 person-years. A total of 1093 patients received at least 1 year, and 415 patients at least 2 years of treatment with PLEGRIDY. A total of 512 and 500 patients, respectively, received PLEGRIDY 125 micrograms every 14 days or every 28 days during the placebo-controlled phase of Study 1 (year 1). The experience in year 2 of Study 1 and in the 2-year safety extension study (Study 2) was consistent with the experience in the 1-year placebo-controlled phase of Study 1.

In the placebo-controlled phase of Study 1, the most common adverse drug reactions for PLEGRIDY 125 micrograms subcutaneously every 14 days were injection site erythema, influenza-like illness, pyrexia, headache, myalgia, chills, injection site pain, asthenia, injection site pruritus, and arthralgia (all had incidence more than 10% and at least 2% more than placebo). The most commonly reported adverse event leading to discontinuation in patients treated with PLEGRIDY 125 micrograms subcutaneously every 14 days was influenza-like illness (in less than 1% of patients).

Table 3 summarizes adverse reactions reported over 48 weeks from patients treated in the placebo-controlled phase of Study 1 who received subcutaneous PLEGRIDY 125 micrograms (n=512), or placebo (n=500), every 14 days.

<div class="scrollingtable"><table width="100%"> <caption> <span>Table 3: Adverse Reactions in the 48-Week Placebo-Controlled Phase of Study 1 with an Incidence 2% Higher for PLEGRIDY Than for Placebo </span> </caption> <col align="left" width="47.400%"/> <col align="left" width="25.767%"/> <col align="left" width="26.833%"/> <thead> <tr class="First Last"> <th align="left" class="Botrule Lrule Rrule Toprule" valign="top"></th><th align="center" class="Botrule Rrule Toprule" valign="top"><span class="Bold">PLEGRIDY</span> <br/> <span class="Bold">(N=512)</span> <br/> <span class="Bold">%</span></th><th align="center" class="Botrule Rrule Toprule" valign="top"><span class="Bold">Placebo</span> <br/> <span class="Bold">(N=500)</span> <br/> <span class="Bold">%</span></th> </tr> </thead> <tbody> <tr class="First"> <td align="left" class="Lrule Rrule" valign="top"><span class="Bold">Nervous System Disorders</span></td><td align="center" class="Rrule" valign="top"></td><td align="center" class="Rrule" valign="top"></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top">Headache </td><td align="center" class="Botrule Rrule" valign="top">44 </td><td align="center" class="Botrule Rrule" valign="top">33 </td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top"><span class="Bold">Gastrointestinal Disorders</span></td><td align="center" class="Rrule" valign="top"></td><td align="center" class="Rrule" valign="top"></td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top">Nausea </td><td align="center" class="Rrule" valign="top">9 </td><td align="center" class="Rrule" valign="top">6 </td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top">Vomiting </td><td align="center" class="Botrule Rrule" valign="top">5 </td><td align="center" class="Botrule Rrule" valign="top">2 </td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top"><span class="Bold">Musculoskeletal and Connective Tissue Disorders</span></td><td align="center" class="Rrule" valign="top"></td><td align="center" class="Rrule" valign="top"></td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top">Myalgia </td><td align="center" class="Rrule" valign="top">19 </td><td align="center" class="Rrule" valign="top">6 </td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top">Arthralgia </td><td align="center" class="Botrule Rrule" valign="top">11 </td><td align="center" class="Botrule Rrule" valign="top">7 </td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top"><span class="Bold">General Disorders and Administration Site Conditions</span></td><td align="center" class="Rrule" valign="top"></td><td align="center" class="Rrule" valign="top"></td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top">Injection site erythema </td><td align="center" class="Rrule" valign="top">62 </td><td align="center" class="Rrule" valign="top">7 </td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top">Influenza like illness </td><td align="center" class="Rrule" valign="top">47 </td><td align="center" class="Rrule" valign="top">13 </td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top">Pyrexia </td><td align="center" class="Rrule" valign="top">45 </td><td align="center" class="Rrule" valign="top">15 </td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top">Chills </td><td align="center" class="Rrule" valign="top">17 </td><td align="center" class="Rrule" valign="top">5 </td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top">Injection site pain </td><td align="center" class="Rrule" valign="top">15 </td><td align="center" class="Rrule" valign="top">3 </td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top">Asthenia </td><td align="center" class="Rrule" valign="top">13 </td><td align="center" class="Rrule" valign="top">8 </td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top">Injection site pruritus </td><td align="center" class="Rrule" valign="top">13 </td><td align="center" class="Rrule" valign="top">1 </td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top">Hyperthermia </td><td align="center" class="Rrule" valign="top">4 </td><td align="center" class="Rrule" valign="top">1 </td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top">Pain </td><td align="center" class="Rrule" valign="top">5 </td><td align="center" class="Rrule" valign="top">3 </td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top">Injection site edema </td><td align="center" class="Rrule" valign="top">3 </td><td align="center" class="Rrule" valign="top">0 </td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top">Injection site warmth </td><td align="center" class="Rrule" valign="top">3 </td><td align="center" class="Rrule" valign="top">0 </td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top">Injection site hematoma </td><td align="center" class="Rrule" valign="top">3 </td><td align="center" class="Rrule" valign="top">1 </td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top">Injection site rash </td><td align="center" class="Botrule Rrule" valign="top">2 </td><td align="center" class="Botrule Rrule" valign="top">0 </td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top"><span class="Bold">Investigations</span></td><td align="center" class="Rrule" valign="top"></td><td align="center" class="Rrule" valign="top"></td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top">Body temperature increased </td><td align="center" class="Rrule" valign="top">6 </td><td align="center" class="Rrule" valign="top">3 </td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top">Alanine aminotransferase increased </td><td align="center" class="Rrule" valign="top">6 </td><td align="center" class="Rrule" valign="top">3 </td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top">Aspartate aminotransferase increased </td><td align="center" class="Rrule" valign="top">4 </td><td align="center" class="Rrule" valign="top">2 </td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top">Gamma-glutamyl-transferase increased </td><td align="center" class="Botrule Rrule" valign="top">3 </td><td align="center" class="Botrule Rrule" valign="top">1 </td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top"><span class="Bold">Skin and Subcutaneous Tissue Disorder</span></td><td align="center" class="Rrule" valign="top"></td><td align="center" class="Rrule" valign="top"></td> </tr> <tr class="Last"> <td align="left" class="Botrule Lrule Rrule" valign="top">Pruritus </td><td align="center" class="Botrule Rrule" valign="top">4 </td><td align="center" class="Botrule Rrule" valign="top">1 </td> </tr> </tbody> </table></div>

Flu-Like Symptoms

Influenza-like illness was experienced by 47% of patients receiving PLEGRIDY 125 micrograms every 14 days and 13% of patients receiving placebo. Fewer than 1% of PLEGRIDY-treated patients in Study 1 discontinued treatment due to flu-like symptoms.

Comparison Between Subcutaneous and Intramuscular Administration

An open-label, crossover study analyzed findings from 130 healthy volunteers to assess the bioequivalence of single doses of 125 micrograms of PLEGRIDY administered as a subcutaneous and intramuscular injection (Study 3).

The most commonly reported adverse reactions (with >10% incidence in either arm) across both treatment periods were chills (36% in IM vs 27% in SC), pain (22% in IM vs 14% in SC), headache (36% in IM vs 41% in SC), injection site pain (11% in IM vs 15% in SC), and injection site erythema (2% in IM vs 25% in SC). Overall, injection site reactions were reported in 14% via IM route as compared to 32% via SC route.

As with all therapeutic proteins, there is a potential for immunogenicity.

The detection of antibody formation is highly dependent on the sensitivity and specificity of the assay. Additionally, the observed incidence of antibody (including neutralizing antibody) positivity in an assay may be influenced by several factors including assay methodology, sample handling, timing of sample collection, concomitant medications, and underlying disease. For these reasons, comparison of the incidence of antibodies in the studies described below with the incidence of antibodies in other studies or to other interferon beta-1a products may be misleading.

In Study 1, fewer than 1% of patients treated with PLEGRIDY SC every 14 days for 1 year developed neutralizing antibodies. Approximately 7% of PLEGRIDY SC-treated patients developed antibodies to the polyethylene glycol moiety.

No formal studies have been conducted with regards to immunogenicity of the intramuscular route of administration of PLEGRIDY.

The following adverse reactions have been identified during post-approval use of PLEGRIDY. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Anaphylactic reactions

In post marketing experience, serious hypersensitivity reactions, including cases of anaphylaxis, have been reported following PLEGRIDY administration [see Warnings and Precautions (5.3)].

Hepatic injury

In post marketing experience, noninfectious hepatitis (including serious hepatitis) cases have been reported following PLEGRIDY administration [see Warnings and Precautions (5.1)].

Pulmonary Arterial Hypertension

In postmarketing experience, pulmonary arterial hypertension has been reported following PLEGRIDY administration [see Warnings and Precautions (5.8)].

Risk Summary

Data from a large population-based cohort study, as well as other published studies over several decades, have not identified a drug-associated risk of major birth defects with the use of interferon beta products during early pregnancy. Findings regarding a potential risk for low birth weight or miscarriage with the use of interferon beta products in pregnancy have been inconsistent (see Data). In a study in pregnant monkeys, administration of interferon beta during pregnancy resulted in an increased rate of abortion (see Data).

In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2-4% and 15-20%, respectively. The background risk of major birth defects and miscarriage for the indicated population is unknown.

Data

Human Data

The majority of observational studies reporting on pregnancies exposed to interferon beta products did not identify an association between the use of interferon beta products during early pregnancy and an increased risk of major birth defects.

In a population-based cohort study conducted in Finland and Sweden, data were collected from 1996--2014 in Finland and 2005--2014 in Sweden on 2,831 pregnancy outcomes from women with MS. 797 pregnancies were in women exposed to interferon beta only. No evidence was found of an increased risk of major birth defects among women with MS exposed to interferon beta products compared to women with MS that were unexposed to any non-steroid therapy for MS (n=1,647) within the study. No increased risks were observed for miscarriages and ectopic pregnancies, though there were limitations in obtaining complete data capture for these outcomes, making the interpretation of the findings more difficult.

Two small cohort studies that examined pregnancies exposed to interferon beta products (without differentiating between subtypes of interferon beta products) suggested that a decrease in mean birth weight may be associated with interferon beta exposure during pregnancy, but this finding was not confirmed in larger observational studies. Two small studies observed an increased prevalence of miscarriage, although the finding was only statistically significant in one study. Most studies enrolled patients later in pregnancy, which made it difficult to ascertain the true percentage of miscarriages. In one small cohort study, a significantly increased risk of preterm birth following interferon beta exposure during pregnancy was observed.

Animal Data

PLEGRIDY has not been tested for developmental toxicity in pregnant animals. In monkeys given interferon beta by subcutaneous injection every other day during early pregnancy, no adverse effects on embryofetal development were observed. Abortifacient activity was evident following 3 to 5 doses.

Risk Summary

Limited published literature has described the presence of interferon beta-1a products in human milk at low levels. There are no data on the effects of interferon beta-1a on milk production. Therefore, the developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for PLEGRIDY and any potential adverse effects on the breastfed infant from PLEGRIDY or from the underlying maternal condition.

Safety and effectiveness in pediatric patients have not been established.

Clinical studies of PLEGRIDY did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients.

Monitor for adverse reactions due to increased drug exposure in patients with severe renal impairment [see Clinical Pharmacology (12.3)].

Subcutaneous Administration

PLEGRIDY (peginterferon beta-1a) injection is a sterile, preservative-free solution in a single-dose prefilled pen or single-dose prefilled syringe with a 29-gauge, 0.5-inch needle for subcutaneous use. Each prefilled pen or prefilled syringe delivers 0.5 mL. Each 0.5 mL contains 63 mcg, 94 mcg, or 125 mcg of peginterferon beta-1a, and L-arginine HCl (15.8 mg), glacial acetic acid (0.25 mg), polysorbate 20 (0.025 mg), and sodium acetate trihydrate (0.79 mg) in Water for Injection, USP. The pH is approximately 4.8.

Intramuscular Administration

PLEGRIDY (peginterferon beta-1a) injection is a sterile, preservative-free solution in a single-dose prefilled syringe with a 23-gauge, 1.25-inch needle for intramuscular use. Each prefilled syringe delivers 0.5 mL. Each 0.5 mL contains 125 mcg of peginterferon beta-1a, and L-arginine HCl (15.8 mg), glacial acetic acid (0.25 mg), polysorbate 20 (0.025 mg), and sodium acetate trihydrate (0.79 mg) in Water for Injection, USP. The pH is approximately 4.8.

The mechanism by which PLEGRIDY exerts its effects in patients with multiple sclerosis is unknown.

There is no biochemical or physiologic effect known to relate directly to the clinical effect of PLEGRIDY.

After single-dose or multiple-dose subcutaneous administration of PLEGRIDY to healthy subjects, serum PLEGRIDY peak concentration (Cmax) and total exposure over time (area under the curve, or AUC) increased in proportion to doses from 63 to 188 micrograms. PLEGRIDY did not accumulate in the serum after multiple doses of 125 micrograms every 14 days. Pharmacokinetic parameters for PLEGRIDY, including Cmax and AUC, did not differ significantly between healthy volunteers and multiple sclerosis patients or between single-dose and multiple-dose administrations. However, the coefficient of variation between individual patients for AUC, Cmax, and half-life was high (41% to 68%, 74% to 89%, and 45% to 93%, respectively).

Absorption

After 125 microgram subcutaneous doses of PLEGRIDY in multiple sclerosis patients, the maximum concentration occurred between 1 and 1.5 days, the mean Cmax was 280 pg/mL, and the AUC over the 14 day dosing interval was 34.8 ng.hr/mL.

Distribution

In multiple sclerosis patients taking 125 microgram subcutaneous doses of PLEGRIDY every 14 days, the estimated volume of distribution was 481 liters.

Metabolism and Elimination

Clearance mechanisms for PLEGRIDY include catabolism and excretion. The major pathway of elimination is renal. The half-life is approximately 78 hours in multiple sclerosis patients. The mean steady state clearance of PLEGRIDY is approximately 4.1 L/hr. PLEGRIDY is not extensively metabolized in the liver.

The pharmacokinetics of 125 μg single dose of PLEGRIDY administered subcutaneously and intramuscularly were similar.

Specific Populations

Body weight, gender, and age do not require dosage adjustment.

Renal impairment can increase the Cmax and AUC for PLEGRIDY. Results of a pharmacokinetic study in patients with mild, moderate, and severe renal impairment (creatinine clearance 50 to 80, 30 to 50, and less than 30 mL/minute, respectively) showed increases above normal for Cmax of 27%, 26%, and 42%, and for AUC, increases of 30%, 40%, and 53%. The half-life was 53, 49, and 82 hours in patients with mild, moderate, and severe renal impairment, respectively, compared to 54 hours in normal subjects.

In the same study, subjects with end stage renal disease requiring hemodialysis two or three times weekly had AUC and Cmax of PLEGRIDY values that were similar to those of normal controls. Each hemodialysis session removed approximately 24% of circulating PLEGRIDY from the systemic circulation [see Use in Specific Populations (8.6)].

Carcinogenesis

The carcinogenic potential of PLEGRIDY has not been tested in animals.

Mutagenesis

PLEGRIDY was not mutagenic when tested in an in vitro bacterial reverse mutation (Ames) test and was not clastogenic in an in vitro assay in human lymphocytes.

Impairment of Fertility

In monkeys administered interferon beta by subcutaneous injection over the course of one menstrual cycle, menstrual irregularities, anovulation, and decreased serum progesterone levels were observed. These effects were reversible after discontinuation of drug.

The efficacy of PLEGRIDY was demonstrated in the randomized, double-blind, and placebo-controlled phase (year 1) of Study 1. The trial compared clinical and MRI outcomes at 48 weeks in patients who received PLEGRIDY 125 micrograms (n=512) or placebo (n=500) by the subcutaneous route, once every 14 days.

{ "type": "p", "children": [], "text": "The efficacy of PLEGRIDY was demonstrated in the randomized, double-blind, and placebo-controlled phase (year 1) of Study 1. The trial compared clinical and MRI outcomes at 48 weeks in patients who received PLEGRIDY 125 micrograms (n=512) or placebo (n=500) by the subcutaneous route, once every 14 days.\n" }

Study 1 enrolled patients who had a baseline Expanded Disability Status Scale (EDSS) score from 0 to 5, who had experienced at least 2 relapses within the previous three years, and had experienced at least 1 relapse in the previous year. The trial excluded patients with progressive forms of multiple sclerosis. The mean age of the study population was 37 years, the mean disease duration was 3.6 years, and the mean EDSS score at baseline was 2.46. The majority of the patients were women (71%).

{ "type": "p", "children": [], "text": "Study 1 enrolled patients who had a baseline Expanded Disability Status Scale (EDSS) score from 0 to 5, who had experienced at least 2 relapses within the previous three years, and had experienced at least 1 relapse in the previous year. The trial excluded patients with progressive forms of multiple sclerosis. The mean age of the study population was 37 years, the mean disease duration was 3.6 years, and the mean EDSS score at baseline was 2.46. The majority of the patients were women (71%).\n" }

The trial scheduled neurological evaluations at baseline, every 12 weeks, and at the time of a suspected relapse. Brain MRI evaluations were scheduled at baseline, week 24, and week 48.

{ "type": "p", "children": [], "text": "The trial scheduled neurological evaluations at baseline, every 12 weeks, and at the time of a suspected relapse. Brain MRI evaluations were scheduled at baseline, week 24, and week 48.\n" }

The primary outcome was the annualized relapse rate over 1 year. Secondary outcomes included the proportion of patients relapsing, number of new or newly enlarging T2 hyperintense lesions, and time to confirmed disability progression. Confirmed disability progression was defined as follows: if the baseline EDSS score was 0, a sustained 12-week increase in EDSS score of 1.5 points was required; if the baseline EDSS score was greater than 0, a sustained 12-week increase in EDSS score of 1 point was required. Table 4 and Figure 1 show the results of Study 1.

{ "type": "p", "children": [], "text": "The primary outcome was the annualized relapse rate over 1 year. Secondary outcomes included the proportion of patients relapsing, number of new or newly enlarging T2 hyperintense lesions, and time to confirmed disability progression. Confirmed disability progression was defined as follows: if the baseline EDSS score was 0, a sustained 12-week increase in EDSS score of 1.5 points was required; if the baseline EDSS score was greater than 0, a sustained 12-week increase in EDSS score of 1 point was required. Table 4 and Figure 1 show the results of Study 1.\n" }

<div class="scrollingtable"><table width="100%"> <caption> <span>Table 4: Clinical and MRI Results of Study 1 </span> </caption> <col align="left" width="50.638%"/> <col align="left" width="22.056%"/> <col align="left" width="13.653%"/> <col align="left" width="13.653%"/> <thead> <tr class="First Last"> <th align="center" class="Botrule Lrule Rrule Toprule" valign="top"><span class="Bold">Endpoint</span></th><th align="center" class="Botrule Rrule Toprule" valign="top"><span class="Bold">PLEGRIDY</span> <br/> <span class="Bold">125 micrograms</span> <br/> <span class="Bold">every 14 days</span></th><th align="center" class="Botrule Rrule Toprule" valign="top"><span class="Bold">Placebo</span></th><th align="center" class="Botrule Rrule Toprule" valign="top"><span class="Bold">p-value</span></th> </tr> </thead> <tbody> <tr class="First"> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Clinical outcomes at 48 weeks</span></td><td align="center" class="Botrule Rrule" valign="top"><span class="Bold">N=512</span></td><td align="center" class="Botrule Rrule" valign="top"><span class="Bold">N=500</span></td><td align="center" class="Botrule Rrule" valign="top"></td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top">Annualized relapse rate </td><td align="center" class="Rrule" valign="top">0.26 </td><td align="center" class="Rrule" valign="top">0.40 </td><td align="center" class="Rrule" valign="top">0.0007 </td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top">     Relative reduction </td><td align="center" class="Botrule Rrule" valign="top">36% </td><td align="center" class="Botrule Rrule" valign="top"></td><td align="center" class="Botrule Rrule" valign="top"></td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top">Proportion of patients with relapses </td><td align="center" class="Rrule" valign="top">0.19 </td><td align="center" class="Rrule" valign="top">0.29 </td><td align="center" class="Rrule" valign="top">0.0003 </td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top">     Relative risk reduction </td><td align="center" class="Botrule Rrule" valign="top">39% </td><td align="center" class="Botrule Rrule" valign="top"></td><td align="center" class="Botrule Rrule" valign="top"></td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top">Proportion of patients with disability progression </td><td align="center" class="Rrule" valign="top">0.07 </td><td align="center" class="Rrule" valign="top">0.11 </td><td align="center" class="Rrule" valign="top">0.0383 </td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top">     Relative risk reduction </td><td align="center" class="Botrule Rrule" valign="top">38% </td><td align="center" class="Botrule Rrule" valign="top"></td><td align="center" class="Botrule Rrule" valign="top"></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">MRI outcomes at 48 weeks</span></td><td align="center" class="Botrule Rrule" valign="top"><span class="Bold">N=457</span></td><td align="center" class="Botrule Rrule" valign="top"><span class="Bold">N=476</span></td><td align="center" class="Botrule Rrule" valign="top"></td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top">Mean number of new or newly enlarging T2 hyperintense lesions </td><td align="center" class="Rrule" valign="top">3.6 </td><td align="center" class="Rrule" valign="top">10.9 </td><td align="center" class="Rrule" valign="top">&lt;0.0001 </td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top">     Relative reduction </td><td align="center" class="Botrule Rrule" valign="top">67% </td><td align="center" class="Botrule Rrule" valign="top"></td><td align="center" class="Botrule Rrule" valign="top"></td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top">Mean number of Gd enhancing lesions </td><td align="center" class="Rrule" valign="top">0.2 </td><td align="center" class="Rrule" valign="top">1.4 </td><td align="center" class="Rrule" valign="top">&lt;0.0001 </td> </tr> <tr class="Last"> <td align="left" class="Botrule Lrule Rrule" valign="top">     Relative reduction </td><td align="center" class="Botrule Rrule" valign="top">86% </td><td align="center" class="Botrule Rrule" valign="top"></td><td align="center" class="Botrule Rrule" valign="top"></td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table width=\"100%\">\n<caption>\n<span>Table 4: Clinical and MRI Results of Study 1\n</span>\n</caption>\n<col align=\"left\" width=\"50.638%\"/>\n<col align=\"left\" width=\"22.056%\"/>\n<col align=\"left\" width=\"13.653%\"/>\n<col align=\"left\" width=\"13.653%\"/>\n<thead>\n<tr class=\"First Last\">\n<th align=\"center\" class=\"Botrule Lrule Rrule Toprule\" valign=\"top\"><span class=\"Bold\">Endpoint</span></th><th align=\"center\" class=\"Botrule Rrule Toprule\" valign=\"top\"><span class=\"Bold\">PLEGRIDY</span>\n<br/>\n<span class=\"Bold\">125 micrograms</span>\n<br/>\n<span class=\"Bold\">every 14 days</span></th><th align=\"center\" class=\"Botrule Rrule Toprule\" valign=\"top\"><span class=\"Bold\">Placebo</span></th><th align=\"center\" class=\"Botrule Rrule Toprule\" valign=\"top\"><span class=\"Bold\">p-value</span></th>\n</tr>\n</thead>\n<tbody>\n<tr class=\"First\">\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Clinical outcomes at 48 weeks</span></td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><span class=\"Bold\">N=512</span></td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><span class=\"Bold\">N=500</span></td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Lrule Rrule\" valign=\"top\">Annualized relapse rate\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">0.26\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">0.40\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">0.0007\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">     Relative reduction\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">36%\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"></td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Lrule Rrule\" valign=\"top\">Proportion of patients with relapses\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">0.19\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">0.29\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">0.0003\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">     Relative risk reduction\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">39%\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"></td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Lrule Rrule\" valign=\"top\">Proportion of patients with disability progression\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">0.07\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">0.11\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">0.0383\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">     Relative risk reduction\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">38%\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"></td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">MRI outcomes at 48 weeks</span></td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><span class=\"Bold\">N=457</span></td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><span class=\"Bold\">N=476</span></td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Lrule Rrule\" valign=\"top\">Mean number of new or newly enlarging T2 hyperintense lesions\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">3.6\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">10.9\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">&lt;0.0001\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">     Relative reduction\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">67%\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"></td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Lrule Rrule\" valign=\"top\">Mean number of Gd enhancing lesions\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">0.2\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">1.4\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">&lt;0.0001\n</td>\n</tr>\n<tr class=\"Last\">\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">     Relative reduction\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">86%\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"></td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"></td>\n</tr>\n</tbody>\n</table></div>" }

Figure 1: Time to first relapse

{ "type": "p", "children": [], "text": "\nFigure 1: Time to first relapse\n" }

PLEGRIDY (peginterferon beta-1a) injection is a sterile, preservative-free, clear to slightly opalescent and colorless to slightly yellow solution supplied as a 0.5 mL single-dose prefilled pen or a 0.5 mL single-dose prefilled syringe.

Subcutaneous Administration

PLEGRIDY (peginterferon beta-1a) injection for subcutaneous use is supplied as a single-dose prefilled pen or single-dose prefilled syringe with a rubber stopper and a 29-gauge, 0.5-inch staked needle with a rigid needle shield in the following packaging configurations:

Intramuscular Administration

PLEGRIDY (peginterferon beta-1a) injection for intramuscular use is supplied as a single-dose prefilled syringe with a rubber stopper and a 23-gauge, 1.25-inch staked needle provided separately with the syringe in the following packaging configurations:

Store PLEGRIDY prefilled pens and prefilled syringes in a refrigerator between 2°C to 8°C (36°F to 46°F) in the closed original carton to protect from light until ready for injection. Do not freeze. Discard if frozen.

If refrigeration is unavailable, PLEGRIDY may be stored at room temperature up to 25°C (77°F) for a period up to 30 days, protected from light. PLEGRIDY can be removed from, and returned to, a refrigerator if necessary. The total combined time out of refrigeration should not exceed 30 days.

PLEGRIDY prefilled syringe for intramuscular administration contains natural rubber latex which may cause allergic reactions.

Dispose in a sharps-bin container or other hard plastic or metal sealable container. Always follow local regulations for disposal.

Instructions for Self-Injection Technique and Procedures

Provide appropriate instruction for methods of self-injection, including careful review of the PLEGRIDY Medication Guide and Instructions for Use. Instruct patients in the use of aseptic technique when administering PLEGRIDY.

Inform patients that a healthcare provider should show them or their caregiver how to prepare to inject PLEGRIDY before administering the first dose. Tell patients not to re-use needles or syringes, and instruct patients on safe disposal procedures. Inform patients to dispose of used needles and syringes in a puncture-resistant container, and instruct patients regarding safe disposal of full containers.

Advise patients:

Pregnancy

Advise patients to notify their healthcare provider if they become pregnant during treatment or plan to become pregnant [see Use in Specific Populations (8.1)].

Liver Disease

Advise patients that severe hepatic injury, including rare cases of hepatic failure, has been reported during the use of interferon beta. Advise patients of symptoms of hepatic dysfunction, and instruct patients to report them immediately to their physician [see Warnings and Precautions (5.1)].

Depression and Suicide

Advise patients that depression, suicidal ideation, and suicide have been reported with the use of interferon beta. Instruct patients to report symptoms of depression or thoughts of suicide to their physician immediately [see Warnings and Precautions (5.2)].

Anaphylaxis and Other Allergic Reactions

Advise patients of the symptoms of allergic reactions and anaphylaxis, and instruct patients to seek immediate medical attention if these symptoms occur. Inform latex-sensitive patients that the PLEGRIDY prefilled syringe for intramuscular administration contains natural rubber latex [see Warnings and Precautions (5.3)].

Injection Site Reactions Including Necrosis

Advise patients that injection site reactions can occur and that the reactions can include injection site necrosis. Instruct patients to report promptly any break in the skin that is associated with blue-black discoloration, swelling, or drainage of fluid from the injection site [see Warnings and Precautions (5.4)].

Cardiac Disease

Advise patients that worsening of significant cardiac disease has been reported in patients using interferon beta. Advise patients of symptoms of worsening cardiac condition, and instruct patients to report them immediately to their physician [see Warnings and Precautions (5.5)].

Pulmonary Arterial Hypertension

Inform patients that PAH has occurred in patients treated with interferon beta products, including PLEGRIDY. Instruct patients to promptly report any new symptoms such as new or increasing fatigue or shortness of breath to their healthcare provider [see Warnings and Precautions (5.8)].

Seizure

Advise patients that seizures have been reported in patients using PLEGRIDY. Instruct patients to report seizures immediately to their physician [see Warnings and Precautions (5.10)].

Flu-like Symptoms

Inform patients that flu-like symptoms are common following initiation of therapy with PLEGRIDY. Prophylactic and concurrent use of analgesics and/or antipyretics may prevent or ameliorate flu-like symptoms sometimes experienced during interferon treatment [see Dosage and Administration (2.3) and Adverse Reactions (6.1)].

43643-09

Manufactured by:Biogen Inc.Cambridge, MA 02142U.S. License # 16971-800-456-2255PLEGRIDY is a registered trademark of Biogen. ©2013-2023 Biogen

<div class="scrollingtable"><table width="100%"> <col align="left" width="85.000%"/> <col align="left" width="15.000%"/> <tfoot> <tr class="First Last"> <td align="left" valign="top"> <p class="First Footnote">This Medication Guide has been approved by the U.S. Food and Drug Administration. </p> </td><td align="right" valign="top"> <p class="First Footnote">Revised: 7/2023 </p> </td> </tr> </tfoot> <tbody class="Headless"> <tr class="First"> <td align="center" class="Botrule Lrule Rrule Toprule" colspan="2" valign="top"><span class="Bold">Medication Guide<br/> </span>PLEGRIDY<span class="Sup">®</span> (PLEGG-rih-dee)<br/>(peginterferon beta-1a)<br/>injection, for subcutaneous or intramuscular use </td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" colspan="2" valign="top">Read this Medication Guide before you start using PLEGRIDY, and each time you get a refill. There may be new information. This information does not take the place of talking with your healthcare provider about your medical condition or your treatment. </td> </tr> <tr> <td align="left" class="Lrule Rrule" colspan="2" valign="top"> <p class="First"> <a name="p00"></a><span class="Bold">What is the most important information I should know about PLEGRIDY?</span> </p> </td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" colspan="2" valign="top"><span class="Bold">PLEGRIDY can cause serious side effects, including:</span> <br/> <ul class="Disc"> <li> <span class="Bold">Liver problems or worsening of liver problems, including liver failure and death.</span> Symptoms may include: yellowing of your skin or the white part of your eye, nausea, loss of appetite, tiredness, bleeding more easily than normal, confusion, sleepiness, dark colored urine, and pale stools.<br/>During your treatment with PLEGRIDY you will need to see your healthcare provider and have regular blood tests to check for these possible side effects. </li> <li> <span class="Bold">Depression or suicidal thoughts.</span> Symptoms may include: new or worsening depression (feeling hopeless or bad about yourself), thoughts of hurting yourself or suicide, irritability (getting upset easily), nervousness, or new or worsening anxiety. </li> <li> <span class="Bold">Call your healthcare provider right away if you have any of the symptoms listed above.</span> </li> </ul> </td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" colspan="2" valign="top"><span class="Bold">What is PLEGRIDY?</span> <ul class="Disc"> <li>PLEGRIDY is a prescription medicine used to treat relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults. </li> <li>It is not known if PLEGRIDY is safe and effective in people under 18 or over 65 years of age. </li> </ul> </td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" colspan="2" valign="top"><span class="Bold">Do not take PLEGRIDY if you:</span> <ul class="Disc"> <li>are allergic to interferon beta or peginterferon, or any of the other ingredients in PLEGRIDY. See the end of this Medication Guide for a complete list of ingredients in PLEGRIDY. </li> </ul> </td> </tr> <tr> <td align="left" class="Lrule Rrule" colspan="2" valign="top"><span class="Bold">Before using PLEGRIDY, tell your healthcare provider about all of your medical conditions, including if you:</span> <ul class="Disc"> <li>are being treated for a mental illness or had treatment in the past for any mental illness, including depression and suicidal behavior. </li> <li>have or had liver problems. </li> <li>have or had low blood cell counts. </li> <li>have or had bleeding problems. </li> <li>have or had heart problems. </li> <li>have or had seizures (epilepsy). </li> <li>have or had thyroid problems. </li> <li>have or had any kind of autoimmune disease (where the body's immune system attacks the body's own cells). </li> <li>have or had an allergic reaction to rubber or latex. The tip of the cap of the PLEGRIDY prefilled syringe for intramuscular use is made of natural rubber latex. </li> <li>are pregnant or plan to become pregnant. It is not known if PLEGRIDY can harm your unborn baby. Tell your healthcare provider if you become pregnant during your treatment with PLEGRIDY. </li> <li>are breastfeeding or plan to breastfeed. PLEGRIDY may pass into your breastmilk. Talk to your healthcare provider about the best way to feed your baby if you use PLEGRIDY.<br/> </li> </ul> </td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" colspan="2" valign="top">Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. </td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" colspan="2" valign="top"><span class="Bold">How should I use PLEGRIDY?</span> <ul class="Disc"> <li>See the detailed <span class="Bold"><a href="#s78">Instructions for Use</a></span> for instructions on how to prepare and inject your dose of PLEGRIDY. </li> <li>Use PLEGRIDY exactly as your healthcare provider tells you. A healthcare provider should show you how to inject your PLEGRIDY before you use it for the first time. </li> <li>Your healthcare provider will tell you how much PLEGRIDY to inject and how often to inject PLEGRIDY. Do not inject more than your healthcare provider tells you to. </li> <li>When you use PLEGRIDY for the first time, your healthcare provider may tell you to slowly increase your dose. </li> <li>If you are prescribed PLEGRIDY for injection under the skin (subcutaneous injection):<ul class="Circle"> <li>you should use a PLEGRIDY Starter Pack to slowly adjust your dose when you begin treatment. </li> <li>inject PLEGRIDY under the skin of your stomach (abdomen), back of upper arm, or thigh 1 time every 14 days. </li> </ul> </li> <li>If you are prescribed PLEGRIDY for injection into the muscle (intramuscular injection):<ul class="Circle"> <li>you should use a PLEGRIDY Titration Kit to slowly adjust your dose when you begin treatment. </li> <li>inject PLEGRIDY into your thigh 1 time every 14 days. </li> </ul> </li> <li>If your healthcare provider changes where you are injecting PLEGRIDY (under the skin or into the muscle), you do not need to slowly increase your dose again. </li> <li>Change (rotate) the site you choose with each injection to help decrease the chance that you will have an injection site reaction. <span class="Bold">Do not</span> inject into an area of the body where the skin is irritated, reddened, bruised, infected, or scarred in any way. </li> <li>After 2 hours check your injection site for redness, pain, itching, swelling, tenderness, a break in your skin that becomes blue and black, or drains fluid. If you have a skin reaction and it does not clear up in a few days, contact your healthcare provider. </li> <li>Always use a new, PLEGRIDY prefilled pen or new, unopened single dose prefilled syringe for each injection. </li> </ul> </td> </tr> <tr> <td align="left" class="Lrule Rrule" colspan="2" valign="top"><span class="Bold">What are the possible side effects of PLEGRIDY?</span></td> </tr> <tr> <td align="left" class="Lrule Rrule" colspan="2" valign="top"><span class="Bold">See “<a href="#p00">What is the most important information I should know about PLEGRIDY?</a>”</span> <br/> <span class="Bold">PLEGRIDY may cause serious side effects, including:</span> <br/> <ul class="Disc"> <li> <span class="Bold">serious allergic reactions.</span> Serious allergic reactions can happen if you take PLEGRIDY. Symptoms may include: itching, swelling of the face, eyes, lips, tongue, or throat, trouble breathing, feeling faint, anxiousness, skin rash, hives, skin bumps. Get emergency help right away if you have any of these symptoms. Talk to your healthcare provider before taking another dose of PLEGRIDY. </li> <li> <span class="Bold">injection site reactions.</span> PLEGRIDY may commonly cause redness, pain, itching, or swelling at the place where your injection was given. Call your healthcare provider right away if an injection site becomes swollen and painful or the area looks infected. You may have a skin infection or an area of severe skin damage (necrosis) requiring treatment by a healthcare provider. </li> <li> <span class="Bold">heart problems, including congestive heart failure.</span> Call your healthcare provider right away if you have worsening symptoms of heart failure such as shortness of breath or swelling of your lower legs or feet while using PLEGRIDY.<ul class="Circle"> <li>Some people using PLEGRIDY may have other heart problems, including low blood pressure, fast or abnormal heart beat, chest pain, heart attack, or a heart muscle problem (cardiomyopathy). </li> </ul> </li> <li> <span class="Bold">blood problems and changes in your blood tests.</span> PLEGRIDY can decrease your white blood cells or platelets, which can cause an increased risk of infection, bleeding, or anemia and can cause changes in your liver function tests. Your healthcare provider will do tests to monitor for side effects while you use PLEGRIDY. </li> <li> <span class="Bold">thrombotic microangiopathy (TMA).</span> TMA is a condition that involves injury to the smallest blood vessels in your body. TMA can also cause injury to your red cells (the cells that carry oxygen to your organs and tissues) and your platelets (cells that help your blood clot) and can sometimes lead to death. Your healthcare provider may tell you to stop taking PLEGRIDY if you develop TMA. </li> <li> <span class="Bold">pulmonary arterial hypertension.</span> Pulmonary arterial hypertension can occur with interferon beta products, including PLEGRIDY. Symptoms may include new or increasing fatigue or shortness of breath. Contact your healthcare provider right away if you develop these symptoms. </li> <li> <span class="Bold">autoimmune diseases.</span> Problems with easy bleeding or bruising (idiopathic thrombocytopenia), thyroid gland problems (hyperthyroidism and hypothyroidism), and autoimmune hepatitis have happened in some people who use interferon beta. </li> <li> <span class="Bold">seizures</span>. Some people have had seizures while taking PLEGRIDY, including people who have never had seizures before. </li> </ul> <span class="Bold">The most common side effects of PLEGRIDY include:</span> <ul class="Disc"> <li> <span class="Bold">flu-like symptoms.</span> Many people who use PLEGRIDY have flu-like symptoms, especially early in the course of therapy. These symptoms are not really the flu. You cannot pass it on to anyone else.<ul class="Circle"> <li>You may be able to manage these flu-like symptoms by taking over-the-counter pain and fever reducers and drinking plenty of water. </li> </ul> </li> </ul> </td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" colspan="2" valign="top"><span class="Bold">Flu-like symptoms or other common side effects of PLEGRIDY may include:</span> headache, muscle and joint aches, fever, chills, or tiredness.<br/>These are not all the possible side effects of PLEGRIDY.<br/>Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. </td> </tr> <tr> <td align="left" class="Lrule Rrule" colspan="2" valign="top"><span class="Bold">General Information about the safe and effective use of PLEGRIDY.</span></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" colspan="2" valign="top">Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use PLEGRIDY for a condition for which it was not prescribed. Do not give PLEGRIDY to other people, even if they have the same symptoms that you have. It may harm them. You can ask your pharmacist or healthcare provider for information about PLEGRIDY that is written for health professionals. </td> </tr> <tr> <td align="left" class="Lrule Rrule" colspan="2" valign="top"><span class="Bold">What are the ingredients in PLEGRIDY?</span></td> </tr> <tr> <td align="left" class="Lrule Rrule" colspan="2" valign="top"><span class="Bold">Active ingredient:</span> peginterferon beta-1a. </td> </tr> <tr> <td align="left" class="Lrule Rrule" colspan="2" valign="top"><span class="Bold">Inactive ingredients:</span></td> </tr> <tr> <td align="left" class="Lrule Rrule" colspan="2" valign="top"> <ul class="Disc"> <li> <span class="Bold">Single-dose Prefilled Pen (subcutaneous injection only):</span> L-arginine hydrochloride, glacial acetic acid, polysorbate 20, and sodium acetate trihydrate in sterile water for injection.<br/> </li> <li> <span class="Bold">Single-dose Prefilled Syringe (subcutaneous and intramuscular injection):</span> L-arginine hydrochloride, glacial acetic acid, polysorbate 20, and sodium acetate trihydrate in sterile water for injection. </li> </ul> </td> </tr> <tr class="Last"> <td align="left" class="Botrule Lrule Rrule" colspan="2" valign="top">For more information, go to www.plegridy.com or call 1-800-456-2255.<br/>Manufactured by: Biogen Inc., Cambridge, MA 02142, U.S. License # 1697<br/>PLEGRIDY is a registered trademark of Biogen. ©2013-2023 Biogen </td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table width=\"100%\">\n<col align=\"left\" width=\"85.000%\"/>\n<col align=\"left\" width=\"15.000%\"/>\n<tfoot>\n<tr class=\"First Last\">\n<td align=\"left\" valign=\"top\">\n<p class=\"First Footnote\">This Medication Guide has been approved by the U.S. Food and Drug Administration.\n</p>\n</td><td align=\"right\" valign=\"top\">\n<p class=\"First Footnote\">Revised: 7/2023\n</p>\n</td>\n</tr>\n</tfoot>\n<tbody class=\"Headless\">\n<tr class=\"First\">\n<td align=\"center\" class=\"Botrule Lrule Rrule Toprule\" colspan=\"2\" valign=\"top\"><span class=\"Bold\">Medication Guide<br/>\n</span>PLEGRIDY<span class=\"Sup\">®</span> (PLEGG-rih-dee)<br/>(peginterferon beta-1a)<br/>injection, for subcutaneous or intramuscular use\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" colspan=\"2\" valign=\"top\">Read this Medication Guide before you start using PLEGRIDY, and each time you get a refill. There may be new information. This information does not take the place of talking with your healthcare provider about your medical condition or your treatment.\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Lrule Rrule\" colspan=\"2\" valign=\"top\">\n<p class=\"First\">\n<a name=\"p00\"></a><span class=\"Bold\">What is the most important information I should know about PLEGRIDY?</span>\n</p>\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" colspan=\"2\" valign=\"top\"><span class=\"Bold\">PLEGRIDY can cause serious side effects, including:</span>\n<br/>\n<ul class=\"Disc\">\n<li>\n<span class=\"Bold\">Liver problems or worsening of liver problems, including liver failure and death.</span> Symptoms may include: yellowing of your skin or the white part of your eye, nausea, loss of appetite, tiredness, bleeding more easily than normal, confusion, sleepiness, dark colored urine, and pale stools.<br/>During your treatment with PLEGRIDY you will need to see your healthcare provider and have regular blood tests to check for these possible side effects.\n</li>\n<li>\n<span class=\"Bold\">Depression or suicidal thoughts.</span> Symptoms may include: new or worsening depression (feeling hopeless or bad about yourself), thoughts of hurting yourself or suicide, irritability (getting upset easily), nervousness, or new or worsening anxiety.\n</li>\n<li>\n<span class=\"Bold\">Call your healthcare provider right away if you have any of the symptoms listed above.</span>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" colspan=\"2\" valign=\"top\"><span class=\"Bold\">What is PLEGRIDY?</span>\n<ul class=\"Disc\">\n<li>PLEGRIDY is a prescription medicine used to treat relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.\n</li>\n<li>It is not known if PLEGRIDY is safe and effective in people under 18 or over 65 years of age.\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" colspan=\"2\" valign=\"top\"><span class=\"Bold\">Do not take PLEGRIDY if you:</span>\n<ul class=\"Disc\">\n<li>are allergic to interferon beta or peginterferon, or any of the other ingredients in PLEGRIDY. See the end of this Medication Guide for a complete list of ingredients in PLEGRIDY.\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Lrule Rrule\" colspan=\"2\" valign=\"top\"><span class=\"Bold\">Before using PLEGRIDY, tell your healthcare provider about all of your medical conditions, including if you:</span>\n<ul class=\"Disc\">\n<li>are being treated for a mental illness or had treatment in the past for any mental illness, including depression and suicidal behavior.\n</li>\n<li>have or had liver problems.\n</li>\n<li>have or had low blood cell counts.\n</li>\n<li>have or had bleeding problems.\n</li>\n<li>have or had heart problems.\n</li>\n<li>have or had seizures (epilepsy).\n</li>\n<li>have or had thyroid problems.\n</li>\n<li>have or had any kind of autoimmune disease (where the body's immune system attacks the body's own cells).\n</li>\n<li>have or had an allergic reaction to rubber or latex. The tip of the cap of the PLEGRIDY prefilled syringe for intramuscular use is made of natural rubber latex.\n</li>\n<li>are pregnant or plan to become pregnant. It is not known if PLEGRIDY can harm your unborn baby. Tell your healthcare provider if you become pregnant during your treatment with PLEGRIDY.\n</li>\n<li>are breastfeeding or plan to breastfeed. PLEGRIDY may pass into your breastmilk. Talk to your healthcare provider about the best way to feed your baby if you use PLEGRIDY.<br/>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" colspan=\"2\" valign=\"top\">Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" colspan=\"2\" valign=\"top\"><span class=\"Bold\">How should I use PLEGRIDY?</span>\n<ul class=\"Disc\">\n<li>See the detailed <span class=\"Bold\"><a href=\"#s78\">Instructions for Use</a></span> for instructions on how to prepare and inject your dose of PLEGRIDY.\n</li>\n<li>Use PLEGRIDY exactly as your healthcare provider tells you. A healthcare provider should show you how to inject your PLEGRIDY before you use it for the first time.\n</li>\n<li>Your healthcare provider will tell you how much PLEGRIDY to inject and how often to inject PLEGRIDY. Do not inject more than your healthcare provider tells you to.\n</li>\n<li>When you use PLEGRIDY for the first time, your healthcare provider may tell you to slowly increase your dose.\n</li>\n<li>If you are prescribed PLEGRIDY for injection under the skin (subcutaneous injection):<ul class=\"Circle\">\n<li>you should use a PLEGRIDY Starter Pack to slowly adjust your dose when you begin treatment.\n</li>\n<li>inject PLEGRIDY under the skin of your stomach (abdomen), back of upper arm, or thigh 1 time every 14 days.\n</li>\n</ul>\n</li>\n<li>If you are prescribed PLEGRIDY for injection into the muscle (intramuscular injection):<ul class=\"Circle\">\n<li>you should use a PLEGRIDY Titration Kit to slowly adjust your dose when you begin treatment.\n</li>\n<li>inject PLEGRIDY into your thigh 1 time every 14 days.\n</li>\n</ul>\n</li>\n<li>If your healthcare provider changes where you are injecting PLEGRIDY (under the skin or into the muscle), you do not need to slowly increase your dose again.\n</li>\n<li>Change (rotate) the site you choose with each injection to help decrease the chance that you will have an injection site reaction. <span class=\"Bold\">Do not</span> inject into an area of the body where the skin is irritated, reddened, bruised, infected, or scarred in any way.\n</li>\n<li>After 2 hours check your injection site for redness, pain, itching, swelling, tenderness, a break in your skin that becomes blue and black, or drains fluid. If you have a skin reaction and it does not clear up in a few days, contact your healthcare provider.\n</li>\n<li>Always use a new, PLEGRIDY prefilled pen or new, unopened single dose prefilled syringe for each injection.\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Lrule Rrule\" colspan=\"2\" valign=\"top\"><span class=\"Bold\">What are the possible side effects of PLEGRIDY?</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Lrule Rrule\" colspan=\"2\" valign=\"top\"><span class=\"Bold\">See “<a href=\"#p00\">What is the most important information I should know about PLEGRIDY?</a>”</span>\n<br/>\n<span class=\"Bold\">PLEGRIDY may cause serious side effects, including:</span>\n<br/>\n<ul class=\"Disc\">\n<li>\n<span class=\"Bold\">serious allergic reactions.</span> Serious allergic reactions can happen if you take PLEGRIDY. Symptoms may include: itching, swelling of the face, eyes, lips, tongue, or throat, trouble breathing, feeling faint, anxiousness, skin rash, hives, skin bumps. Get emergency help right away if you have any of these symptoms. Talk to your healthcare provider before taking another dose of PLEGRIDY.\n</li>\n<li>\n<span class=\"Bold\">injection site reactions.</span> PLEGRIDY may commonly cause redness, pain, itching, or swelling at the place where your injection was given. Call your healthcare provider right away if an injection site becomes swollen and painful or the area looks infected. You may have a skin infection or an area of severe skin damage (necrosis) requiring treatment by a healthcare provider.\n</li>\n<li>\n<span class=\"Bold\">heart problems, including congestive heart failure.</span> Call your healthcare provider right away if you have worsening symptoms of heart failure such as shortness of breath or swelling of your lower legs or feet while using PLEGRIDY.<ul class=\"Circle\">\n<li>Some people using PLEGRIDY may have other heart problems, including low blood pressure, fast or abnormal heart beat, chest pain, heart attack, or a heart muscle problem (cardiomyopathy).\n</li>\n</ul>\n</li>\n<li>\n<span class=\"Bold\">blood problems and changes in your blood tests.</span> PLEGRIDY can decrease your white blood cells or platelets, which can cause an increased risk of infection, bleeding, or anemia and can cause changes in your liver function tests. Your healthcare provider will do tests to monitor for side effects while you use PLEGRIDY.\n</li>\n<li>\n<span class=\"Bold\">thrombotic microangiopathy (TMA).</span> TMA is a condition that involves injury to the smallest blood vessels in your body. TMA can also cause injury to your red cells (the cells that carry oxygen to your organs and tissues) and your platelets (cells that help your blood clot) and can sometimes lead to death. Your healthcare provider may tell you to stop taking PLEGRIDY if you develop TMA.\n</li>\n<li>\n<span class=\"Bold\">pulmonary arterial hypertension.</span> Pulmonary arterial hypertension can occur with interferon beta products, including PLEGRIDY. Symptoms may include new or increasing fatigue or shortness of breath. Contact your healthcare provider right away if you develop these symptoms.\n</li>\n<li>\n<span class=\"Bold\">autoimmune diseases.</span> Problems with easy bleeding or bruising (idiopathic thrombocytopenia), thyroid gland problems (hyperthyroidism and hypothyroidism), and autoimmune hepatitis have happened in some people who use interferon beta.\n</li>\n<li>\n<span class=\"Bold\">seizures</span>. Some people have had seizures while taking PLEGRIDY, including people who have never had seizures before.\n</li>\n</ul>\n<span class=\"Bold\">The most common side effects of PLEGRIDY include:</span>\n<ul class=\"Disc\">\n<li>\n<span class=\"Bold\">flu-like symptoms.</span> Many people who use PLEGRIDY have flu-like symptoms, especially early in the course of therapy. These symptoms are not really the flu. You cannot pass it on to anyone else.<ul class=\"Circle\">\n<li>You may be able to manage these flu-like symptoms by taking over-the-counter pain and fever reducers and drinking plenty of water.\n</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" colspan=\"2\" valign=\"top\"><span class=\"Bold\">Flu-like symptoms or other common side effects of PLEGRIDY may include:</span> headache, muscle and joint aches, fever, chills, or tiredness.<br/>These are not all the possible side effects of PLEGRIDY.<br/>Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Lrule Rrule\" colspan=\"2\" valign=\"top\"><span class=\"Bold\">General Information about the safe and effective use of PLEGRIDY.</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" colspan=\"2\" valign=\"top\">Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use PLEGRIDY for a condition for which it was not prescribed. Do not give PLEGRIDY to other people, even if they have the same symptoms that you have. It may harm them. You can ask your pharmacist or healthcare provider for information about PLEGRIDY that is written for health professionals.\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Lrule Rrule\" colspan=\"2\" valign=\"top\"><span class=\"Bold\">What are the ingredients in PLEGRIDY?</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Lrule Rrule\" colspan=\"2\" valign=\"top\"><span class=\"Bold\">Active ingredient:</span> peginterferon beta-1a.\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Lrule Rrule\" colspan=\"2\" valign=\"top\"><span class=\"Bold\">Inactive ingredients:</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Lrule Rrule\" colspan=\"2\" valign=\"top\">\n<ul class=\"Disc\">\n<li>\n<span class=\"Bold\">Single-dose Prefilled Pen (subcutaneous injection only):</span> L-arginine hydrochloride, glacial acetic acid, polysorbate 20, and sodium acetate trihydrate in sterile water for injection.<br/>\n</li>\n<li>\n<span class=\"Bold\">Single-dose Prefilled Syringe (subcutaneous and intramuscular injection):</span> L-arginine hydrochloride, glacial acetic acid, polysorbate 20, and sodium acetate trihydrate in sterile water for injection.\n</li>\n</ul>\n</td>\n</tr>\n<tr class=\"Last\">\n<td align=\"left\" class=\"Botrule Lrule Rrule\" colspan=\"2\" valign=\"top\">For more information, go to www.plegridy.com or call 1-800-456-2255.<br/>Manufactured by: Biogen Inc., Cambridge, MA 02142, U.S. License # 1697<br/>PLEGRIDY is a registered trademark of Biogen. ©2013-2023 Biogen\n</td>\n</tr>\n</tbody>\n</table></div>" }

Instructions for Use

{ "type": "p", "children": [], "text": "\nInstructions for Use\n" }

PLEGRIDY®(PLEGG-rih-dee)

{ "type": "p", "children": [], "text": "\nPLEGRIDY®(PLEGG-rih-dee)\n" }

(peginterferon beta-1a) injection, for Subcutaneous Use

{ "type": "p", "children": [], "text": "\n(peginterferon beta-1a) injection, for Subcutaneous Use\n" }

Single-Dose Prefilled Pen

{ "type": "p", "children": [], "text": "\nSingle-Dose Prefilled Pen\n" }

Starter Pack

{ "type": "p", "children": [], "text": "\nStarter Pack\n" }

Important: Do not remove the Plegridy Pen cap until you are ready to inject.

{ "type": "p", "children": [], "text": "\nImportant: Do not remove the Plegridy Pen cap until you are ready to inject.\n" }

How to Inject your Plegridy Pen

{ "type": "p", "children": [], "text": "\nHow to Inject your Plegridy Pen\n" }

Read this Instructions for Use before you start using Plegridy and each time you get a refill of your prescription. There may be new information. This information does not take the place of talking to your healthcare provider about your medical condition or your treatment.

{ "type": "p", "children": [], "text": "Read this Instructions for Use before you start using Plegridy and each time you get a refill of your prescription. There may be new information. This information does not take the place of talking to your healthcare provider about your medical condition or your treatment.\n" }

Note:

{ "type": "p", "children": [], "text": "\nNote:\n" }

{ "type": "ul", "children": [ "\nBefore you use your Plegridy Pen for the first time, your healthcare provider should show you or your caregiver how to prepare and inject your Plegridy Pen the right way.\n", "If you experience difficulty or have questions, call 1-800-456-2255.\n", "Plegridy Pen is for use under the skin only (subcutaneous).\n", "\nEach Plegridy Pen can be used 1 time only. Do not share your Plegridy Pen with anyone else. By sharing the Pen, you may give an infection to them or get an infection from them.\n", "\nTake your Plegridy Pen out of the refrigerator and let it come to room temperature for at least 30 minutes before your injection.\n", "\nDo not use more than 1 Plegridy Pen every 14 days.\n", "\nDo not use your Plegridy Pen if it has been dropped or is visibly damaged.\n" ], "text": "" }

How should I store Plegridy?

{ "type": "p", "children": [], "text": "\nHow should I store Plegridy?\n" }

{ "type": "ul", "children": [ "Store Plegridy in the refrigerator between 36°F to 46°F (2°C to 8°C).\n", "If a refrigerator is not available, PLEGRIDY may be stored at room temperature up to 77°F (25°C) for up to 30 days in total.\n", "Keep Plegridy in the original carton to protect it from light.\n", "\nDo not freeze Plegridy.\n", "\nKeep Plegridy Pens, needles, and all medicines out of the reach of children.\n" ], "text": "" }

Supplies needed for your Starter Pack for Plegridy Pen injection (See Figure A):

{ "type": "p", "children": [], "text": "\nSupplies needed for your Starter Pack for Plegridy Pen injection (See Figure A):\n" }

{ "type": "ul", "children": [ "1 Starter Pack for Plegridy Pen which contains:\n1 Plegridy 63 mcg Pen (orange pen)\n\n1 Plegridy 94 mcg Pen (blue pen)\n\n\n\n" ], "text": "" }

Additional supplies which are not included in the pack (See Figure B):

{ "type": "p", "children": [], "text": "Additional supplies which are not included in the pack (See Figure B):\n" }

{ "type": "ul", "children": [ "alcohol wipe\n", "gauze pad\n", "adhesive bandage\n", "1 sharps container for throwing away used needles and Plegridy Pens. See “Disposing of your used Plegridy Pens” at the end of these instructions.\n", "a well-lit area and a clean, flat surface to work on, like a table\n\n" ], "text": "" }

Dose Schedule

{ "type": "p", "children": [], "text": "\nDose Schedule\n" }

{ "type": "ul", "children": [ "\nChoose the right Plegridy Pen for your dose. The Starter Pack for Plegridy Pen contains your first 2 injections to slowly adjust your dose.\n" ], "text": "" }

<div class="scrollingtable"><table class="Noautorules" width="100%"> <col align="left" width="28.400%"/> <col align="left" width="26.300%"/> <col align="left" width="45.300%"/> <tbody class="Headless"> <tr> <td align="left" class="Botrule Lrule Rrule Toprule" valign="top"><span class="Bold">When</span></td><td align="justify" class="Botrule Rrule Toprule" valign="top"><span class="Bold">Which Dose</span></td><td align="justify" class="Botrule Rrule Toprule" valign="top"><span class="Bold">Choose</span></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Day 1</span> <br/>(63 mcg) </td><td align="center" class="Botrule Rrule" valign="top"><span class="Bold">First Dose:</span> <br/>63 mcg<br/> </td><td align="center" class="Botrule Rrule" valign="top"><span class="Bold">Orange</span> Pen (See <a href="#f04">Figure C</a>)<br/> <br/> <a name="f04"></a><img alt="Figure C " src="/dailymed/image.cfm?name=ple00-0024-04.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">When</span></td><td align="justify" class="Botrule Rrule" valign="top"><span class="Bold">Which Dose</span></td><td align="justify" class="Botrule Rrule" valign="top"><span class="Bold">Choose</span></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Day 15</span> <br/>(94 mcg) </td><td align="center" class="Botrule Rrule" valign="top"><span class="Bold">Second Dose:</span> <br/>94 mcg </td><td align="center" class="Botrule Rrule" valign="top"><span class="Bold">Blue</span> Pen (See <a href="#f05">Figure D</a>)<br/> <br/> <br/> <a name="f05"></a><img alt="Figure D " src="/dailymed/image.cfm?name=ple00-0024-05.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table class=\"Noautorules\" width=\"100%\">\n<col align=\"left\" width=\"28.400%\"/>\n<col align=\"left\" width=\"26.300%\"/>\n<col align=\"left\" width=\"45.300%\"/>\n<tbody class=\"Headless\">\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule Toprule\" valign=\"top\"><span class=\"Bold\">When</span></td><td align=\"justify\" class=\"Botrule Rrule Toprule\" valign=\"top\"><span class=\"Bold\">Which Dose</span></td><td align=\"justify\" class=\"Botrule Rrule Toprule\" valign=\"top\"><span class=\"Bold\">Choose</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Day 1</span>\n<br/>(63 mcg)\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><span class=\"Bold\">First Dose:</span>\n<br/>63 mcg<br/>\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><span class=\"Bold\">Orange</span> Pen (See <a href=\"#f04\">Figure C</a>)<br/>\n<br/>\n<a name=\"f04\"></a><img alt=\"Figure C\n\" src=\"/dailymed/image.cfm?name=ple00-0024-04.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">When</span></td><td align=\"justify\" class=\"Botrule Rrule\" valign=\"top\"><span class=\"Bold\">Which Dose</span></td><td align=\"justify\" class=\"Botrule Rrule\" valign=\"top\"><span class=\"Bold\">Choose</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Day 15</span>\n<br/>(94 mcg)\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><span class=\"Bold\">Second Dose:</span>\n<br/>94 mcg\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><span class=\"Bold\">Blue</span> Pen (See <a href=\"#f05\">Figure D</a>)<br/>\n<br/>\n<br/>\n<a name=\"f05\"></a><img alt=\"Figure D\n\" src=\"/dailymed/image.cfm?name=ple00-0024-05.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n</tbody>\n</table></div>" }

{ "type": "ul", "children": [ "\nMake sure you use the 63 mcg orange pen for your first dose (on day 1).\n", "\nMake sure you use the 94 mcg blue pen for your second dose (on day 15).\n" ], "text": "" }

Ask your healthcare provider which Plegridy Pen you should use for your correct dose if you are not sure.

{ "type": "p", "children": [], "text": "Ask your healthcare provider which Plegridy Pen you should use for your correct dose if you are not sure.\n" }

Before Use – Parts of your Plegridy Pen before use (See Figure E):

{ "type": "p", "children": [], "text": "\nBefore Use – Parts of your Plegridy Pen before use (See Figure E):\n" }

Important: Do not remove the Plegridy Pen cap until you are ready to inject. If you remove the cap before you are ready to inject, do not re-cap the pen. Re-capping could cause the pen to lock.

{ "type": "p", "children": [], "text": "\nImportant: Do not remove the Plegridy Pen cap until you are ready to inject. If you remove the cap before you are ready to inject, do not re-cap the pen. Re-capping could cause the pen to lock.\n" }

Preparing for your injection:

{ "type": "p", "children": [], "text": "\nPreparing for your injection:\n" }

Step 1: Take your Plegridy Pen out of the refrigerator and let it come to room temperature for at least 30 minutes.

{ "type": "p", "children": [], "text": "\nStep 1: Take your Plegridy Pen out of the refrigerator and let it come to room temperature for at least 30 minutes.\n" }

{ "type": "ul", "children": [ "\nDo not use external heat sources such as hot water to warm your Plegridy Pen.\n" ], "text": "" }

Step 2: Collect your supplies and wash your hands

{ "type": "p", "children": [], "text": "\nStep 2: Collect your supplies and wash your hands\n" }

{ "type": "ul", "children": [ "Find a well-lit area and a clean, flat surface like a table and collect all the supplies you will need to give yourself or to receive an injection.\n", "Wash your hands with soap and water.\n" ], "text": "" }

Step 3: Check your Plegridy Pen (see Figure F)

{ "type": "p", "children": [], "text": "\nStep 3: Check your Plegridy Pen (see Figure F)\n" }

<div class="scrollingtable"><table class="Noautorules" width="100%"> <col align="left" width="57.500%"/> <col align="left" width="42.500%"/> <tbody class="Headless"> <tr> <td align="left" class="Botrule Lrule Rrule Toprule" valign="top"> <ul class="Disc"> <li>Check the injection status window on your Plegridy Pen. Before you give your injection, you should see green stripes in the injection status window.<ul class="Circle"> <li> <span class="Bold">Do not</span> use Plegridy Pen if you do not see the green stripes in the injection status window.<br/> </li> </ul> </li> </ul> </td><td align="center" class="Botrule Rrule Toprule" rowspan="3" valign="top"> <br/> <br/> <br/> <a name="f07"></a><img alt="Figure F " src="/dailymed/image.cfm?name=ple00-0024-07.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"> <ul class="Disc"> <li>Check the expiration date printed on your Plegridy Pen.<ul class="Circle"> <li> <span class="Bold">Do not</span> use Plegridy Pen past the expiration date. </li> </ul> </li> </ul> </td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"> <ul class="Disc"> <li>Check the medicine window on your Plegridy Pen and make sure the Plegridy medicine is clear and colorless.<ul class="Circle"> <li> <span class="Bold">Do not</span> use Plegridy Pen if the liquid is colored, cloudy, or has floating particles in it. </li> <li>You might see air bubbles in the medicine window. This is normal and will not affect your dose. </li> </ul> </li> </ul> </td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table class=\"Noautorules\" width=\"100%\">\n<col align=\"left\" width=\"57.500%\"/>\n<col align=\"left\" width=\"42.500%\"/>\n<tbody class=\"Headless\">\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule Toprule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>Check the injection status window on your Plegridy Pen. Before you give your injection, you should see green stripes in the injection status window.<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">Do not</span> use Plegridy Pen if you do not see the green stripes in the injection status window.<br/>\n</li>\n</ul>\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule Toprule\" rowspan=\"3\" valign=\"top\">\n<br/>\n<br/>\n<br/>\n<a name=\"f07\"></a><img alt=\"Figure F\n\" src=\"/dailymed/image.cfm?name=ple00-0024-07.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>Check the expiration date printed on your Plegridy Pen.<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">Do not</span> use Plegridy Pen past the expiration date.\n</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>Check the medicine window on your Plegridy Pen and make sure the Plegridy medicine is clear and colorless.<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">Do not</span> use Plegridy Pen if the liquid is colored, cloudy, or has floating particles in it.\n</li>\n<li>You might see air bubbles in the medicine window. This is normal and will not affect your dose.\n</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table></div>" }

<div class="scrollingtable"><table class="Noautorules" width="100%"> <col align="left" width="34.950%"/> <col align="left" width="4.700%"/> <col align="left" width="10%"/> <col align="left" width="59.400%"/> <tbody class="Headless"> <tr> <td align="left" class="Botrule" colspan="4" valign="top"><span class="Bold">Step 4: Choose and clean your injection site</span></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" colspan="2" valign="top"> <ul class="Disc"> <li>Plegridy Pen is for use under the skin only (subcutaneous). </li> <li>Plegridy Pen should be injected into your thigh, stomach area (abdomen) or the back of your upper arm (See <a href="#f08">Figure G</a>).<ul class="Circle"> <li> <span class="Bold">Do not</span> inject into an area of your body where the skin is irritated, reddened, bruised, infected or scarred. </li> </ul> </li> <li> <span class="Bold">Change (rotate) your injection site</span> for each injection. <span class="Bold">Do not</span> use the same injection site for each injection. </li> <li>Choose an injection site and wipe your skin with an alcohol wipe.<ul class="Circle"> <li> <span class="Bold">Do not</span> touch this area again before giving your injection. </li> </ul> </li> <li>Let your injection site dry on its own before injecting your dose.<br/> </li> </ul> </td><td align="center" class="Botrule Rrule" colspan="2" valign="top"> <br/> <br/> <a name="f08"></a><img alt="Figure G " src="/dailymed/image.cfm?name=ple00-0024-08.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule" colspan="4" valign="top"> <br/> <span class="Bold">Giving your injection:</span> <br/> <br/> <span class="Bold">Step 5: Remove the Plegridy Pen cap</span></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" colspan="3" valign="top"> <ul class="Disc"> <li>Pull the Plegridy Pen cap straight off and set it aside (See Figure H).<ul class="Circle"> <li>The needle is covered by the needle cover and the needle will not be seen. </li> </ul> </li> <li> <span class="Bold">Important information:</span> <ul class="Circle"> <li> <span class="Bold">Do not</span> touch or clean the needle cover. You could get a needle stick injury or the pen may lock. </li> <li> <span class="Bold">Do not</span> recap your Plegridy Pen. This could lock the pen. </li> </ul> </li> <li>Your Plegridy Pen is ready to inject after the cap is removed. </li> </ul> </td><td align="center" class="Botrule Rrule" valign="top"> <br/>Figure H </td> </tr> <tr> <td align="left" class="Botrule" colspan="4" valign="top"><span class="Bold">Step 6: Give your injection</span></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"> <ul class="Disc"> <li>Place your Plegridy Pen on your chosen injection site.<ul class="Circle"> <li>You should hold your Plegridy Pen at a 90<span class="Sup">o</span> angle to your injection site so that you can see the green stripes in the injection status window (See <a href="#f09">Figure I</a>). </li> <li> <span class="Bold">Do not</span> use your Plegridy Pen unless you see green stripes in the injection status window.<p class="First">Note: Be ready to inject before you start pressing your Plegridy Pen down on your injection site. After you start pressing, the needle cover will lock when it is lifted from the site. </p> </li> </ul> </li> <li> <span class="Bold">Firmly press and hold down your Plegridy Pen on your injection site.</span> This will insert the needle and start your injection (See <a href="#f10">Figure J</a>).<ul class="Circle"> <li> <span class="Bold">You will hear a clicking sound.</span> </li> </ul> </li> <li>Continue to hold your Plegridy Pen firmly down on your injection site until the clicking sound has stopped (See <a href="#f11">figure K</a>).<ul class="Circle"> <li> <span class="Bold">Do not</span> lift your Plegridy Pen off your injection site until the clicking sound stops and you see green checkmarks in the injection status window. </li> </ul> </li> </ul> </td><td align="center" class="Botrule Rrule" colspan="3" valign="top"> <br/> <br/> <a name="f09"></a><img alt="Figure I " src="/dailymed/image.cfm?name=ple00-0024-09.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/><br/> <br/> <a name="f10"></a><img alt="Figure J " src="/dailymed/image.cfm?name=ple00-0024-10.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/><br/> <br/> <a name="f11"></a><img alt="Figure K " src="/dailymed/image.cfm?name=ple00-0024-11.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/><br/> </td> </tr> <tr> <td align="left" class="Botrule" colspan="4" valign="top"><span class="Bold">If you do not hear clicking sounds, or you do not see green checkmarks in the injection status window after trying to give your injection, your Plegridy Pen may have locked and you should call 1-800-456-2255 for help.</span> <br/> <br/> <span class="Bold">Step 7: Remove your Plegridy Pen from your injection site</span></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"> <ul class="Disc"> <li>After the clicking sound has stopped, lift your Plegridy Pen from your injection site. The needle will be covered by the needle cover and it will lock (see <a href="#f12">Figure L</a>).<br/> </li> </ul> </td><td align="center" class="Botrule Lrule Rrule" colspan="3" valign="top"> <br/> <a name="f12"></a><img alt="Figure L " src="/dailymed/image.cfm?name=ple00-0024-12.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" colspan="4" valign="top"><span class="Bold">Step 8: Check to make sure you have received your full dose of Plegridy (see <a href="#f13">Figure M</a>)</span></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"> <ul class="Disc"> <li>Check the injection status window. You should see green checkmarks in the injection status. </li> <li>Check the medicine window. You should see a yellow plunger in the medicine.<ul class="Circle"> <li>If you see blood at your injection site, wipe it off with the gauze pad and apply an adhesive bandage.<br/> </li> </ul> </li> </ul> </td><td align="center" class="Botrule Rrule" colspan="3" valign="middle"> <br/> <a name="f13"></a><img alt="Figure M " src="/dailymed/image.cfm?name=ple00-0024-13.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table class=\"Noautorules\" width=\"100%\">\n<col align=\"left\" width=\"34.950%\"/>\n<col align=\"left\" width=\"4.700%\"/>\n<col align=\"left\" width=\"10%\"/>\n<col align=\"left\" width=\"59.400%\"/>\n<tbody class=\"Headless\">\n<tr>\n<td align=\"left\" class=\"Botrule\" colspan=\"4\" valign=\"top\"><span class=\"Bold\">Step 4: Choose and clean your injection site</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" colspan=\"2\" valign=\"top\">\n<ul class=\"Disc\">\n<li>Plegridy Pen is for use under the skin only (subcutaneous).\n</li>\n<li>Plegridy Pen should be injected into your thigh, stomach area (abdomen) or the back of your upper arm (See <a href=\"#f08\">Figure G</a>).<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">Do not</span> inject into an area of your body where the skin is irritated, reddened, bruised, infected or scarred.\n</li>\n</ul>\n</li>\n<li>\n<span class=\"Bold\">Change (rotate) your injection site</span> for each injection. <span class=\"Bold\">Do not</span> use the same injection site for each injection.\n</li>\n<li>Choose an injection site and wipe your skin with an alcohol wipe.<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">Do not</span> touch this area again before giving your injection.\n</li>\n</ul>\n</li>\n<li>Let your injection site dry on its own before injecting your dose.<br/>\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule\" colspan=\"2\" valign=\"top\">\n<br/>\n<br/>\n<a name=\"f08\"></a><img alt=\"Figure G\n\" src=\"/dailymed/image.cfm?name=ple00-0024-08.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule\" colspan=\"4\" valign=\"top\">\n<br/>\n<span class=\"Bold\">Giving your injection:</span>\n<br/>\n<br/>\n<span class=\"Bold\">Step 5: Remove the Plegridy Pen cap</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" colspan=\"3\" valign=\"top\">\n<ul class=\"Disc\">\n<li>Pull the Plegridy Pen cap straight off and set it aside (See Figure H).<ul class=\"Circle\">\n<li>The needle is covered by the needle cover and the needle will not be seen.\n</li>\n</ul>\n</li>\n<li>\n<span class=\"Bold\">Important information:</span>\n<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">Do not</span> touch or clean the needle cover. You could get a needle stick injury or the pen may lock.\n</li>\n<li>\n<span class=\"Bold\">Do not</span> recap your Plegridy Pen. This could lock the pen.\n</li>\n</ul>\n</li>\n<li>Your Plegridy Pen is ready to inject after the cap is removed.\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">\n<br/>Figure H\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule\" colspan=\"4\" valign=\"top\"><span class=\"Bold\">Step 6: Give your injection</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>Place your Plegridy Pen on your chosen injection site.<ul class=\"Circle\">\n<li>You should hold your Plegridy Pen at a 90<span class=\"Sup\">o</span> angle to your injection site so that you can see the green stripes in the injection status window (See <a href=\"#f09\">Figure I</a>).\n</li>\n<li>\n<span class=\"Bold\">Do not</span> use your Plegridy Pen unless you see green stripes in the injection status window.<p class=\"First\">Note: Be ready to inject before you start pressing your Plegridy Pen down on your injection site. After you start pressing, the needle cover will lock when it is lifted from the site.\n</p>\n</li>\n</ul>\n</li>\n<li>\n<span class=\"Bold\">Firmly press and hold down your Plegridy Pen on your injection site.</span> This will insert the needle and start your injection (See <a href=\"#f10\">Figure J</a>).<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">You will hear a clicking sound.</span>\n</li>\n</ul>\n</li>\n<li>Continue to hold your Plegridy Pen firmly down on your injection site until the clicking sound has stopped (See <a href=\"#f11\">figure K</a>).<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">Do not</span> lift your Plegridy Pen off your injection site until the clicking sound stops and you see green checkmarks in the injection status window.\n</li>\n</ul>\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule\" colspan=\"3\" valign=\"top\">\n<br/>\n<br/>\n<a name=\"f09\"></a><img alt=\"Figure I\n\" src=\"/dailymed/image.cfm?name=ple00-0024-09.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/><br/>\n<br/>\n<a name=\"f10\"></a><img alt=\"Figure J\n\" src=\"/dailymed/image.cfm?name=ple00-0024-10.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/><br/>\n<br/>\n<a name=\"f11\"></a><img alt=\"Figure K\n\" src=\"/dailymed/image.cfm?name=ple00-0024-11.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/><br/>\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule\" colspan=\"4\" valign=\"top\"><span class=\"Bold\">If you do not hear clicking sounds, or you do not see green checkmarks in the injection status window after trying to give your injection, your Plegridy Pen may have locked and you should call 1-800-456-2255 for help.</span>\n<br/>\n<br/>\n<span class=\"Bold\">Step 7: Remove your Plegridy Pen from your injection site</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>After the clicking sound has stopped, lift your Plegridy Pen from your injection site. The needle will be covered by the needle cover and it will lock (see <a href=\"#f12\">Figure L</a>).<br/>\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Lrule Rrule\" colspan=\"3\" valign=\"top\">\n<br/>\n<a name=\"f12\"></a><img alt=\"Figure L\n\" src=\"/dailymed/image.cfm?name=ple00-0024-12.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" colspan=\"4\" valign=\"top\"><span class=\"Bold\">Step 8: Check to make sure you have received your full dose of Plegridy (see <a href=\"#f13\">Figure M</a>)</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>Check the injection status window. You should see green checkmarks in the injection status.\n</li>\n<li>Check the medicine window. You should see a yellow plunger in the medicine.<ul class=\"Circle\">\n<li>If you see blood at your injection site, wipe it off with the gauze pad and apply an adhesive bandage.<br/>\n</li>\n</ul>\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule\" colspan=\"3\" valign=\"middle\">\n<br/>\n<a name=\"f13\"></a><img alt=\"Figure M\n\" src=\"/dailymed/image.cfm?name=ple00-0024-13.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n</tbody>\n</table></div>" }

After your injection:

{ "type": "p", "children": [], "text": "\nAfter your injection:\n" }

After Use – Parts of your Plegridy Pen (Figure N)

{ "type": "p", "children": [], "text": "\nAfter Use – Parts of your Plegridy Pen (Figure N)\n" }

Important: Do not touch the needle cover in any way. You could get a needle stick injury.

{ "type": "p", "children": [], "text": "\nImportant: Do not touch the needle cover in any way. You could get a needle stick injury.\n" }

Note: After the pen has been removed from the injection site, the needle cover will lock to protect against needle stick injury. Do not recap your Plegridy Pen.

{ "type": "p", "children": [], "text": "Note: After the pen has been removed from the injection site, the needle cover will lock to protect against needle stick injury. Do not recap your Plegridy Pen.\n" }

Step 9: Disposing of your used Plegridy Pens

{ "type": "p", "children": [], "text": "\nStep 9: Disposing of your used Plegridy Pens\n" }

{ "type": "ul", "children": [ "Put your used Plegridy Pens in a FDA-cleared sharps disposal container right away after use. Do not throw away (dispose of) Plegridy Pens in your household trash.\n", "If you do not have a FDA-cleared sharps disposal container, you may use a household container that is:\nmade of a heavy-duty plastic,\n\ncan be closed with a tight-fitting, puncture-resistant lid, without sharps being able to come out,\n\nupright and stable during use,\n\nleak resistant, and\n\nproperly labeled to warn of hazardous waste inside the container.\n\n\n", "When your sharps disposal container is almost full, you will need to follow your community guidelines for the right way to dispose of your sharps disposal container. There may be state or local laws about how you should throw away used needles and pens. For more information about safe sharps disposal, and for specific information about sharps disposal in the state that you live in, go to the FDA's website at: http://www.fda.gov/safesharpsdisposal.\n", "\nDo not dispose of your used sharps disposal container in your household trash unless your community guidelines permit this. Do not recycle your used sharps disposal container.\n", "\nDo not recap your Plegridy Pen.\n" ], "text": "" }

Step 10: Check your injection site

{ "type": "p", "children": [], "text": "\nStep 10: Check your injection site\n" }

{ "type": "ul", "children": [ "Plegridy may commonly cause redness, pain or swelling of your skin at the injection site.\n", "After 2 hours check your injection site for redness, swelling or tenderness.\n", "Call your healthcare provider right away if your injection site becomes swollen and painful or the area looks infected and does not heal within a few days.\n" ], "text": "" }

Questions?

{ "type": "p", "children": [], "text": "\nQuestions?\n" }

For product or service-related questions, call 1-800-456-2255 or go to www.plegridy.com.

{ "type": "p", "children": [], "text": "For product or service-related questions, call 1-800-456-2255 or go to www.plegridy.com.\n" }

This Instructions for Use has been approved by the U.S. Food and Drug Administration.

{ "type": "p", "children": [], "text": "This Instructions for Use has been approved by the U.S. Food and Drug Administration.\n" }

Manufactured by: Biogen Inc., Cambridge, MA 02142, U.S. License # 1697

{ "type": "p", "children": [], "text": "Manufactured by: Biogen Inc., Cambridge, MA 02142, U.S. License # 1697\n" }

©2013-2022 Biogen. All rights reserved. 1-800-456-2255

{ "type": "p", "children": [], "text": "©2013-2022 Biogen. All rights reserved. 1-800-456-2255\n" }

Issued: 03/2020

{ "type": "p", "children": [], "text": "Issued: 03/2020\n" }

43839-03

{ "type": "p", "children": [], "text": "43839-03\n" }

Instructions for Use

{ "type": "p", "children": [], "text": "\nInstructions for Use\n" }

PLEGRIDY®(PLEGG-rih-dee)

{ "type": "p", "children": [], "text": "\nPLEGRIDY®(PLEGG-rih-dee)\n" }

(peginterferon beta-1a) injection, for Subcutaneous Use

{ "type": "p", "children": [], "text": "\n(peginterferon beta-1a) injection, for Subcutaneous Use\n" }

Single-Dose Prefilled Pen

{ "type": "p", "children": [], "text": "\nSingle-Dose Prefilled Pen\n" }

125 mcg

{ "type": "p", "children": [], "text": "\n125 mcg\n" }

Important: Do not remove the Plegridy Pen cap until you are ready to inject.

{ "type": "p", "children": [], "text": "\nImportant: Do not remove the Plegridy Pen cap until you are ready to inject.\n" }

How to Inject your Plegridy Pen

{ "type": "p", "children": [], "text": "\nHow to Inject your Plegridy Pen\n" }

Read this Instructions for Use before you start using Plegridy and each time you get a refill of your prescription. There may be new information. This information does not take the place of talking to your healthcare provider about your medical condition or your treatment.

{ "type": "p", "children": [], "text": "Read this Instructions for Use before you start using Plegridy and each time you get a refill of your prescription. There may be new information. This information does not take the place of talking to your healthcare provider about your medical condition or your treatment.\n" }

Note:

{ "type": "p", "children": [], "text": "\nNote:\n" }

{ "type": "ul", "children": [ "\nBefore you use your Plegridy Pen for the first time, your healthcare provider should show you or your caregiver how to prepare and inject your Plegridy Pen the right way.\n", "If you experience difficulty or have questions, call 1-800-456-2255.\n", "Plegridy Pen is for use under the skin only (subcutaneous).\n", "\nEach Plegridy Pen can be used 1 time only. Do not share your Plegridy Pen with anyone else. By sharing the Pen, you may give an infection to them or get an infection from them.\n", "\nTake your Plegridy Pen out of the refrigerator and let it come to room temperature for at least 30 minutes before your injection.\n", "\nDo not use more than 1 Plegridy Pen every 14 days.\n", "\nDo not use your Plegridy Pen if it has been dropped or is visibly damaged.\n" ], "text": "" }

How should I store Plegridy?

{ "type": "p", "children": [], "text": "\nHow should I store Plegridy?\n" }

{ "type": "ul", "children": [ "Store Plegridy in the refrigerator between 36°F to 46°F (2°C to 8°C).\n", "If a refrigerator is not available, PLEGRIDY may be stored at room temperature up to 77°F (25°C) for up to 30 days in total.\n", "Keep Plegridy in the original carton to protect it from light.\n", "\nDo not freeze Plegridy.\n", "\nKeep Plegridy Pens, needles, and all medicines out of the reach of children.\n" ], "text": "" }

Supplies needed for your Plegridy Pen injection:

{ "type": "p", "children": [], "text": "\nSupplies needed for your Plegridy Pen injection:\n" }

{ "type": "ul", "children": [ "1 Plegridy 125 mcg Pen (see Figure A)\n" ], "text": "" }

Before Use – Parts of your Plegridy Pen (Figure A)

{ "type": "p", "children": [], "text": "\nBefore Use – Parts of your Plegridy Pen (Figure A)\n" }

Important: Do not remove the Plegridy Pen cap until you are ready to inject. If you remove the cap before you are ready to inject, do not re-cap the pen. Re-capping could cause the pen to lock.

{ "type": "p", "children": [], "text": "\nImportant: Do not remove the Plegridy Pen cap until you are ready to inject. If you remove the cap before you are ready to inject, do not re-cap the pen. Re-capping could cause the pen to lock.\n" }

Additional supplies which are not included in the pack (See Figure B):

{ "type": "p", "children": [], "text": "Additional supplies which are not included in the pack (See Figure B):\n" }

{ "type": "ul", "children": [ "alcohol wipe\n", "gauze pad\n", "adhesive bandage\n", "1 sharps container for throwing away used needles and Plegridy Pens. See “Disposing of your used Plegridy Pens” at the end of these instructions.\n", "a well-lit area and a clean, flat surface to work on, like a table\n\n" ], "text": "" }

Preparing for your injection:

{ "type": "p", "children": [], "text": "\nPreparing for your injection:\n" }

Step 1: Take your Plegridy Pen out of the refrigerator and let it come to room temperature for at least 30 minutes.

{ "type": "p", "children": [], "text": "\nStep 1: Take your Plegridy Pen out of the refrigerator and let it come to room temperature for at least 30 minutes.\n" }

{ "type": "ul", "children": [ "\nDo not use external heat sources such as hot water to warm your Plegridy Pen.\n" ], "text": "" }

Step 2: Collect your supplies and wash your hands

{ "type": "p", "children": [], "text": "\nStep 2: Collect your supplies and wash your hands\n" }

{ "type": "ul", "children": [ "Find a well-lit area and a clean, flat surface like a table and collect all the supplies you will need to give yourself or to receive an injection.\n", "Wash your hands with soap and water.\n" ], "text": "" }

Step 3: Check your Plegridy Pen (see Figure C)

{ "type": "p", "children": [], "text": "\nStep 3: Check your Plegridy Pen (see Figure C)\n" }

<div class="scrollingtable"><table class="Noautorules" width="100%"> <col align="left" width="35.900%"/> <col align="left" width="64.100%"/> <tbody class="Headless"> <tr> <td align="left" class="Botrule Lrule Rrule Toprule" valign="top"> <ul class="Disc"> <li>Check the injection status window on your Plegridy Pen. Before you give your injection, you should see green stripes in the injection status window.<ul class="Circle"> <li> <span class="Bold">Do not</span> use Plegridy Pen if you do not see the green stripes in the injection status window.<br/> </li> </ul> </li> </ul> </td><td align="center" class="Botrule Rrule Toprule" rowspan="3" valign="top"> <br/> <br/> <br/> <a name="f17"></a><img alt="Figure C " src="/dailymed/image.cfm?name=ple00-0024-17.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"> <ul class="Disc"> <li>Check the expiration date printed on your Plegridy Pen.<ul class="Circle"> <li> <span class="Bold">Do not</span> use Plegridy Pen past the expiration date. </li> </ul> </li> </ul> </td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"> <ul class="Disc"> <li>Check the medicine window on your Plegridy Pen and make sure the Plegridy medicine is clear and colorless.<ul class="Circle"> <li> <span class="Bold">Do not</span> use Plegridy Pen if the liquid is colored, cloudy, or has floating particles in it. </li> <li>You might see air bubbles in the medicine window. This is normal and will not affect your dose.<br/> </li> </ul> </li> </ul> </td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table class=\"Noautorules\" width=\"100%\">\n<col align=\"left\" width=\"35.900%\"/>\n<col align=\"left\" width=\"64.100%\"/>\n<tbody class=\"Headless\">\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule Toprule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>Check the injection status window on your Plegridy Pen. Before you give your injection, you should see green stripes in the injection status window.<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">Do not</span> use Plegridy Pen if you do not see the green stripes in the injection status window.<br/>\n</li>\n</ul>\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule Toprule\" rowspan=\"3\" valign=\"top\">\n<br/>\n<br/>\n<br/>\n<a name=\"f17\"></a><img alt=\"Figure C\n\" src=\"/dailymed/image.cfm?name=ple00-0024-17.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>Check the expiration date printed on your Plegridy Pen.<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">Do not</span> use Plegridy Pen past the expiration date.\n</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>Check the medicine window on your Plegridy Pen and make sure the Plegridy medicine is clear and colorless.<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">Do not</span> use Plegridy Pen if the liquid is colored, cloudy, or has floating particles in it.\n</li>\n<li>You might see air bubbles in the medicine window. This is normal and will not affect your dose.<br/>\n</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table></div>" }

<div class="scrollingtable"><table class="Noautorules" width="100%"> <col align="left" width="35.900%"/> <col align="left" width="64.100%"/> <tbody class="Headless"> <tr> <td align="left" class="Botrule" colspan="2" valign="top"><span class="Bold">Step 4: Choose and clean your injection site</span></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"> <ul class="Disc"> <li>Plegridy Pen is for use under the skin only (subcutaneous). </li> <li>Plegridy Pen should be injected into your thigh, abdomen or the back of your upper arm (See <a href="#f18">Figure D</a>).<ul class="Circle"> <li> <span class="Bold">Do not</span> inject into an area of your body where the skin is irritated, reddened, bruised, infected or scarred. </li> </ul> </li> <li> <span class="Bold">Change (rotate) your injection site</span> for each injection. <span class="Bold">Do not</span> use the same injection site for each injection. </li> <li>Choose an injection site and wipe your skin with an alcohol wipe.<ul class="Circle"> <li> <span class="Bold">Do not</span> touch this area again before giving your injection. </li> </ul> </li> <li>Let your injection site dry on its own before injecting your dose.<br/> </li> </ul> </td><td align="center" class="Botrule Rrule" valign="top"> <br/> <br/> <br/> <a name="f18"></a><img alt="Figure D " src="/dailymed/image.cfm?name=ple00-0024-18.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule" colspan="2" valign="top"> <br/> <span class="Bold">Giving your injection:</span> <br/> <br/> <span class="Bold">Step 5: Remove the Plegridy Pen cap</span></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"> <ul class="Disc"> <li>Pull the Plegridy Pen cap straight off and set it aside (See <a href="#f19">Figure E</a>).<ul class="Circle"> <li>The needle is covered by the needle cover and the needle will not be seen. </li> </ul> </li> <li> <span class="Bold">Important information:</span> <ul class="Circle"> <li> <span class="Bold">Do not</span> touch or clean the needle cover. You could get a needle stick injury or the pen may lock. </li> <li> <span class="Bold">Do not</span> recap your Plegridy Pen. This could lock the pen. </li> </ul> </li> <li>Your Plegridy Pen is ready to inject after the cap is removed. </li> </ul> </td><td align="center" class="Botrule Rrule" valign="top"> <br/> <br/> <br/> <br/> <a name="f19"></a><img alt="Figure E " src="/dailymed/image.cfm?name=ple00-0024-19.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/><br/> </td> </tr> <tr> <td align="left" class="Botrule" colspan="2" valign="top"><span class="Bold">Step 6: Give your injection</span></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"> <ul class="Disc"> <li>Place your Plegridy Pen on your chosen injection site.<ul class="Circle"> <li>You should hold your Plegridy Pen at a 90<span class="Sup">o</span> angle to your injection site so that you can see the green stripes in the injection status window (See <a href="#f20">Figure F</a>). </li> <li> <span class="Bold">Do not</span> use your Plegridy Pen unless you see green stripes in the injection status window.<p class="First">Note: Be ready to inject before you start pressing your Plegridy Pen down on your injection site. After you start pressing, the needle cover will lock when it is lifted from the site. </p> </li> </ul> </li> <li> <span class="Bold">Firmly press and hold down your Plegridy Pen on your injection site.</span> This will insert the needle and start your injection (See <a href="#f21">Figure G</a>).<ul class="Circle"> <li> <span class="Bold">You will hear a clicking sound.</span> </li> </ul> </li> <li>Continue to hold your Plegridy Pen firmly down on your injection site until the clicking sound has stopped (see <a href="#f22">Figure H</a>).<ul class="Circle"> <li> <span class="Bold">Do not</span> lift your Plegridy Pen off your injection site until the clicking sound stops and you see green checkmarks in the injection status window. </li> </ul> </li> </ul> </td><td align="center" class="Botrule Rrule" valign="top"> <br/> <br/> <a name="f20"></a><img alt="Figure F " src="/dailymed/image.cfm?name=ple00-0024-20.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/><br/> <br/> <a name="f21"></a><img alt="Figure G " src="/dailymed/image.cfm?name=ple00-0024-21.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/><br/> <a name="f22"></a><img alt="Figure H " src="/dailymed/image.cfm?name=ple00-0024-22.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" colspan="2" valign="top"><span class="Bold">If you do not hear clicking sounds or you do not see green checkmarks in the injection status window after trying to give your injection, your Plegridy Pen may have locked and you should call 1-800-456-2255.</span> <br/> <br/> <span class="Bold">Step 7: Remove your Plegridy Pen from your injection site</span> <br/> <ul class="Disc"> <li>After the clicking sound has stopped, lift your Plegridy Pen from your injection site. The needle will be covered and it will lock (see <a href="#f23">Figure I</a>).<br/> <br/> <br/> <a name="f23"></a><img alt="Figure I " src="/dailymed/image.cfm?name=ple00-0024-23.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/><br/> <br/> <span class="Bold">Step 8: Check and make sure you received your full dose of Plegridy (see <a href="#f24">Figure J</a>)</span> <br/> </li> </ul> </td> </tr> <tr> <td align="left" colspan="2" valign="top"> <ul class="Disc"> <li>Check the injection status window. You should see green checkmarks in the injection status window. </li> <li>Check the medicine window. You should see a yellow plunger in the medicine window.<ul class="Circle"> <li>If you see blood at your injection site, wipe it off with gauze and apply an adhesive bandage.<br/> <a name="f24"></a><img alt="Figure J " src="/dailymed/image.cfm?name=ple00-0024-24.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/><br/> <br/> </li> </ul> </li> </ul> </td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table class=\"Noautorules\" width=\"100%\">\n<col align=\"left\" width=\"35.900%\"/>\n<col align=\"left\" width=\"64.100%\"/>\n<tbody class=\"Headless\">\n<tr>\n<td align=\"left\" class=\"Botrule\" colspan=\"2\" valign=\"top\"><span class=\"Bold\">Step 4: Choose and clean your injection site</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>Plegridy Pen is for use under the skin only (subcutaneous).\n</li>\n<li>Plegridy Pen should be injected into your thigh, abdomen or the back of your upper arm (See <a href=\"#f18\">Figure D</a>).<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">Do not</span> inject into an area of your body where the skin is irritated, reddened, bruised, infected or scarred.\n</li>\n</ul>\n</li>\n<li>\n<span class=\"Bold\">Change (rotate) your injection site</span> for each injection. <span class=\"Bold\">Do not</span> use the same injection site for each injection.\n</li>\n<li>Choose an injection site and wipe your skin with an alcohol wipe.<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">Do not</span> touch this area again before giving your injection.\n</li>\n</ul>\n</li>\n<li>Let your injection site dry on its own before injecting your dose.<br/>\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">\n<br/>\n<br/>\n<br/>\n<a name=\"f18\"></a><img alt=\"Figure D\n\" src=\"/dailymed/image.cfm?name=ple00-0024-18.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule\" colspan=\"2\" valign=\"top\">\n<br/>\n<span class=\"Bold\">Giving your injection:</span>\n<br/>\n<br/>\n<span class=\"Bold\">Step 5: Remove the Plegridy Pen cap</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>Pull the Plegridy Pen cap straight off and set it aside (See <a href=\"#f19\">Figure E</a>).<ul class=\"Circle\">\n<li>The needle is covered by the needle cover and the needle will not be seen.\n</li>\n</ul>\n</li>\n<li>\n<span class=\"Bold\">Important information:</span>\n<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">Do not</span> touch or clean the needle cover. You could get a needle stick injury or the pen may lock.\n</li>\n<li>\n<span class=\"Bold\">Do not</span> recap your Plegridy Pen. This could lock the pen.\n</li>\n</ul>\n</li>\n<li>Your Plegridy Pen is ready to inject after the cap is removed.\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">\n<br/>\n<br/>\n<br/>\n<br/>\n<a name=\"f19\"></a><img alt=\"Figure E\n\" src=\"/dailymed/image.cfm?name=ple00-0024-19.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/><br/>\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule\" colspan=\"2\" valign=\"top\"><span class=\"Bold\">Step 6: Give your injection</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>Place your Plegridy Pen on your chosen injection site.<ul class=\"Circle\">\n<li>You should hold your Plegridy Pen at a 90<span class=\"Sup\">o</span> angle to your injection site so that you can see the green stripes in the injection status window (See <a href=\"#f20\">Figure F</a>).\n</li>\n<li>\n<span class=\"Bold\">Do not</span> use your Plegridy Pen unless you see green stripes in the injection status window.<p class=\"First\">Note: Be ready to inject before you start pressing your Plegridy Pen down on your injection site. After you start pressing, the needle cover will lock when it is lifted from the site.\n</p>\n</li>\n</ul>\n</li>\n<li>\n<span class=\"Bold\">Firmly press and hold down your Plegridy Pen on your injection site.</span> This will insert the needle and start your injection (See <a href=\"#f21\">Figure G</a>).<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">You will hear a clicking sound.</span>\n</li>\n</ul>\n</li>\n<li>Continue to hold your Plegridy Pen firmly down on your injection site until the clicking sound has stopped (see <a href=\"#f22\">Figure H</a>).<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">Do not</span> lift your Plegridy Pen off your injection site until the clicking sound stops and you see green checkmarks in the injection status window.\n</li>\n</ul>\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">\n<br/>\n<br/>\n<a name=\"f20\"></a><img alt=\"Figure F\n\" src=\"/dailymed/image.cfm?name=ple00-0024-20.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/><br/>\n<br/>\n<a name=\"f21\"></a><img alt=\"Figure G\n\" src=\"/dailymed/image.cfm?name=ple00-0024-21.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/><br/>\n<a name=\"f22\"></a><img alt=\"Figure H\n\" src=\"/dailymed/image.cfm?name=ple00-0024-22.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" colspan=\"2\" valign=\"top\"><span class=\"Bold\">If you do not hear clicking sounds or you do not see green checkmarks in the injection status window after trying to give your injection, your Plegridy Pen may have locked and you should call 1-800-456-2255.</span>\n<br/>\n<br/>\n<span class=\"Bold\">Step 7: Remove your Plegridy Pen from your injection site</span>\n<br/>\n<ul class=\"Disc\">\n<li>After the clicking sound has stopped, lift your Plegridy Pen from your injection site. The needle will be covered and it will lock (see <a href=\"#f23\">Figure I</a>).<br/>\n<br/>\n<br/>\n<a name=\"f23\"></a><img alt=\"Figure I\n\" src=\"/dailymed/image.cfm?name=ple00-0024-23.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/><br/>\n<br/>\n<span class=\"Bold\">Step 8: Check and make sure you received your full dose of Plegridy (see <a href=\"#f24\">Figure J</a>)</span>\n<br/>\n</li>\n</ul>\n</td>\n</tr>\n<tr>\n<td align=\"left\" colspan=\"2\" valign=\"top\">\n<ul class=\"Disc\">\n<li>Check the injection status window. You should see green checkmarks in the injection status window.\n</li>\n<li>Check the medicine window. You should see a yellow plunger in the medicine window.<ul class=\"Circle\">\n<li>If you see blood at your injection site, wipe it off with gauze and apply an adhesive bandage.<br/>\n<a name=\"f24\"></a><img alt=\"Figure J\n\" src=\"/dailymed/image.cfm?name=ple00-0024-24.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/><br/>\n<br/>\n</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table></div>" }

After your injection:

{ "type": "p", "children": [], "text": "\nAfter your injection:\n" }

After Use – Parts of your Plegridy Pen (Figure K)

{ "type": "p", "children": [], "text": "\nAfter Use – Parts of your Plegridy Pen (Figure K)\n" }

Important: Do not touch the needle cover in any way. You could get a needle stick injury.

{ "type": "p", "children": [], "text": "\nImportant: Do not touch the needle cover in any way. You could get a needle stick injury.\n" }

Note: After the pen has been removed from the injection site, the needle cover will lock to protect against needle stick injury. Do not recap your Plegridy Pen.

{ "type": "p", "children": [], "text": "Note: After the pen has been removed from the injection site, the needle cover will lock to protect against needle stick injury. Do not recap your Plegridy Pen.\n" }

Step 9: Disposing of your used Plegridy Pens

{ "type": "p", "children": [], "text": "\nStep 9: Disposing of your used Plegridy Pens\n" }

{ "type": "ul", "children": [ "Put your used Plegridy Pens in an FDA-cleared sharps disposal container right away after use. Do not throw away (dispose of) Plegridy Pens in your household trash.\n", "If you do not have an FDA-cleared sharps disposal container, you may use a household container that is:\nmade of a heavy-duty plastic,\n\ncan be closed with a tight-fitting, puncture-resistant lid, without sharps being able to come out,\n\nupright and stable during use,\n\nleak resistant, and\n\nproperly labeled to warn of hazardous waste inside the container.\n\n\n", "When your sharps disposal container is almost full, you will need to follow your community guidelines for the right way to dispose of your sharps disposal container. There may be state or local laws about how you should throw away used needles and pens. For more information about safe sharps disposal, and for specific information about sharps disposal in the state that you live in, go to the FDA's website at: http://www.fda.gov/safesharpsdisposal.\n", "\nDo not dispose of your used sharps disposal container in your household trash unless your community guidelines permit this. Do not recycle your used sharps disposal container.\n", "\nDo not recap your Plegridy Pen.\n" ], "text": "" }

Step 10: Check your injection site

{ "type": "p", "children": [], "text": "\nStep 10: Check your injection site\n" }

{ "type": "ul", "children": [ "Plegridy may commonly cause redness, pain or swelling of your skin at the injection site.\n", "After 2 hours, check your injection site for redness, swelling or tenderness. Call your healthcare provider right away if your injection site becomes swollen and painful or the area looks infected and does not heal within a few days.\n" ], "text": "" }

Questions?

{ "type": "p", "children": [], "text": "\nQuestions?\n" }

For product or service-related questions, call 1-800-456-2255 or go to www.plegridy.com.

{ "type": "p", "children": [], "text": "For product or service-related questions, call 1-800-456-2255 or go to www.plegridy.com.\n" }

This Instructions for Use has been approved by the U.S. Food and Drug Administration.

{ "type": "p", "children": [], "text": "This Instructions for Use has been approved by the U.S. Food and Drug Administration.\n" }

Manufactured by: Biogen Inc., Cambridge, MA 02142, U.S. License # 1697

{ "type": "p", "children": [], "text": "Manufactured by: Biogen Inc., Cambridge, MA 02142, U.S. License # 1697\n" }

©2013-2020 Biogen. All rights reserved. 1-800-456-2255

{ "type": "p", "children": [], "text": "©2013-2020 Biogen. All rights reserved. 1-800-456-2255\n" }

Issued: 03/2020

{ "type": "p", "children": [], "text": "Issued: 03/2020\n" }

43644-03

{ "type": "p", "children": [], "text": "43644-03\n" }

Instructions for Use

{ "type": "p", "children": [], "text": "\nInstructions for Use\n" }

PLEGRIDY®(PLEGG-rih-dee)

{ "type": "p", "children": [], "text": "\nPLEGRIDY®(PLEGG-rih-dee)\n" }

(peginterferon beta-1a) injection for Subcutaneous Use

{ "type": "p", "children": [], "text": "\n(peginterferon beta-1a) injection for Subcutaneous Use\n" }

Single-Dose Prefilled Syringe

{ "type": "p", "children": [], "text": "\nSingle-Dose Prefilled Syringe\n" }

Starter Pack

{ "type": "p", "children": [], "text": "\nStarter Pack\n" }

How to Inject your Plegridy Prefilled Syringe

{ "type": "p", "children": [], "text": "\nHow to Inject your Plegridy Prefilled Syringe\n" }

Read this Instructions for Use before you start using Plegridy and each time you get a refill of your prescription. There may be new information. This information does not take the place of talking to your healthcare provider about your medical condition or your treatment.

{ "type": "p", "children": [], "text": "Read this Instructions for Use before you start using Plegridy and each time you get a refill of your prescription. There may be new information. This information does not take the place of talking to your healthcare provider about your medical condition or your treatment.\n" }

Note:

{ "type": "p", "children": [], "text": "\nNote:\n" }

{ "type": "ul", "children": [ "\nBefore you use your Plegridy Prefilled Syringe for the first time, your healthcare provider should show you or your caregiver how to prepare and inject your Plegridy Prefilled Syringe the right way.\n", "If you experience difficulty or have questions, call 1-800-456-2255.\n", "Plegridy Prefilled Syringe is for use under the skin only (subcutaneous).\n", "\nEach Plegridy Prefilled Syringe can be used 1 time only. Do not share your Plegridy Prefilled Syringe with anyone else. By sharing the needle, you may give an infection to them or get an infection from them.\n", "\nTake your Plegridy Prefilled Syringe out of the refrigerator and let it come to room temperature for at least 30 minutes before your injection.\n", "\nDo not use more than 1 Plegridy Prefilled Syringe every 14 days.\n", "\nDo not use your Plegridy Prefilled Syringe if it has been dropped or is visibly damaged.\n" ], "text": "" }

How should I store Plegridy?

{ "type": "p", "children": [], "text": "\nHow should I store Plegridy?\n" }

{ "type": "ul", "children": [ "Store Plegridy in the refrigerator between 36°F to 46°F (2°C to 8°C).\n", "If a refrigerator is not available, PLEGRIDY may be stored at room temperature up to 77°F (25°C) for up to 30 days in total.\n", "Keep Plegridy in the original carton to protect it from light.\n", "\nDo not freeze Plegridy.\n", "\nKeep Plegridy Prefilled Syringes, needles, and all medicines out of the reach of children.\n" ], "text": "" }

Supplies needed for your Starter Pack for Plegridy Prefilled Syringe injection (See Figure A):

{ "type": "p", "children": [], "text": "\nSupplies needed for your Starter Pack for Plegridy Prefilled Syringe injection (See Figure A):\n" }

{ "type": "ul", "children": [ "1 Starter Pack for Plegridy Prefilled Syringe which contains:\n1 Plegridy 63 mcg Prefilled Syringe (orange syringe)\n\n1 Plegridy 94 mcg Prefilled Syringe (blue syringe)\n\n\n\n" ], "text": "" }

Additional supplies which are not included in the pack (See Figure B):

{ "type": "p", "children": [], "text": "Additional supplies which are not included in the pack (See Figure B):\n" }

{ "type": "ul", "children": [ "alcohol wipe\n", "gauze pad\n", "adhesive bandage\n", "1 sharps container for throwing away used needles and Plegridy Prefilled Syringes. See “Disposing of your used Plegridy Prefilled Syringes” at the end of these instructions.\n", "a well-lit area and a clean, flat surface to work on, like a table\n\n" ], "text": "" }

Dose Schedule

{ "type": "p", "children": [], "text": "\nDose Schedule\n" }

{ "type": "ul", "children": [ "\nChoose the right Plegridy Prefilled Syringe for your dose. The Starter Pack for Plegridy Prefilled Syringe contains your first 2 injections to slowly adjust your dose.\n" ], "text": "" }

<div class="scrollingtable"><table class="Noautorules" width="100%"> <col align="left" width="33.645%"/> <col align="left" width="26.309%"/> <col align="left" width="40.047%"/> <tbody class="Headless"> <tr> <td align="left" class="Botrule Lrule Rrule Toprule" valign="top"><span class="Bold">When</span></td><td align="left" class="Botrule Rrule Toprule" valign="top"><span class="Bold">Which Dose</span></td><td align="left" class="Botrule Rrule Toprule" valign="top"><span class="Bold">Choose</span></td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top"><span class="Bold">Day 1</span> <br/> </td><td align="center" class="Rrule" valign="top"><span class="Bold">First Dose:</span> <br/> </td><td align="left" class="Rrule" valign="top"><span class="Bold">Orange Syringe</span> (See <a href="#f28">Figure C</a>)<br/> </td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top">(63 mcg) </td><td align="center" class="Botrule Rrule" valign="top">63 mcg </td><td align="center" class="Botrule Rrule" valign="top"><a name="f28"></a><img alt="Figure C " src="/dailymed/image.cfm?name=ple00-0024-28.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">When</span></td><td align="left" class="Botrule Rrule" valign="top"><span class="Bold">Which Dose</span></td><td align="left" class="Botrule Rrule" valign="top"><span class="Bold">Choose</span></td> </tr> <tr> <td align="left" class="Lrule Rrule" valign="top"><span class="Bold">Day 15</span> <br/> </td><td align="center" class="Rrule" valign="top"><span class="Bold">Second Dose:</span> <br/> </td><td align="left" class="Rrule" valign="top"><span class="Bold">Blue Syringe</span> (See <a href="#f29">Figure D</a>)<br/> </td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top">(94 mcg) </td><td align="center" class="Botrule Rrule" valign="top">94 mcg </td><td align="center" class="Botrule Rrule" valign="top"><a name="f29"></a><img alt="Figure D " src="/dailymed/image.cfm?name=ple00-0024-29.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table class=\"Noautorules\" width=\"100%\">\n<col align=\"left\" width=\"33.645%\"/>\n<col align=\"left\" width=\"26.309%\"/>\n<col align=\"left\" width=\"40.047%\"/>\n<tbody class=\"Headless\">\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule Toprule\" valign=\"top\"><span class=\"Bold\">When</span></td><td align=\"left\" class=\"Botrule Rrule Toprule\" valign=\"top\"><span class=\"Bold\">Which Dose</span></td><td align=\"left\" class=\"Botrule Rrule Toprule\" valign=\"top\"><span class=\"Bold\">Choose</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Day 1</span>\n<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\"><span class=\"Bold\">First Dose:</span>\n<br/>\n</td><td align=\"left\" class=\"Rrule\" valign=\"top\"><span class=\"Bold\">Orange Syringe</span> (See <a href=\"#f28\">Figure C</a>)<br/>\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">(63 mcg)\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">63 mcg\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><a name=\"f28\"></a><img alt=\"Figure C\n\" src=\"/dailymed/image.cfm?name=ple00-0024-28.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">When</span></td><td align=\"left\" class=\"Botrule Rrule\" valign=\"top\"><span class=\"Bold\">Which Dose</span></td><td align=\"left\" class=\"Botrule Rrule\" valign=\"top\"><span class=\"Bold\">Choose</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Day 15</span>\n<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\"><span class=\"Bold\">Second Dose:</span>\n<br/>\n</td><td align=\"left\" class=\"Rrule\" valign=\"top\"><span class=\"Bold\">Blue Syringe</span> (See <a href=\"#f29\">Figure D</a>)<br/>\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">(94 mcg)\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">94 mcg\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><a name=\"f29\"></a><img alt=\"Figure D\n\" src=\"/dailymed/image.cfm?name=ple00-0024-29.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n</tbody>\n</table></div>" }

{ "type": "ul", "children": [ "\nMake sure you use the 63 mcg orange syringe for your first dose (on day 1).\n", "\nMake sure you use the 94 mcg blue syringe for your second dose (on day 15).\n" ], "text": "" }

Ask your healthcare provider which Plegridy Prefilled Syringe you should use for your correct dose if you are not sure.

{ "type": "p", "children": [], "text": "Ask your healthcare provider which Plegridy Prefilled Syringe you should use for your correct dose if you are not sure.\n" }

Parts of your Plegridy Prefilled Syringe (See Figure E):

{ "type": "p", "children": [], "text": "\nParts of your Plegridy Prefilled Syringe (See Figure E):\n" }

Preparing for your injection:

{ "type": "p", "children": [], "text": "\nPreparing for your injection:\n" }

Step 1: Take your Plegridy Prefilled Syringe out of the refrigerator and let it come to room temperature for at least 30 minutes.

{ "type": "p", "children": [], "text": "\nStep 1: Take your Plegridy Prefilled Syringe out of the refrigerator and let it come to room temperature for at least 30 minutes.\n" }

{ "type": "ul", "children": [ "\nDo not use external heat sources such as hot water to warm your Plegridy Prefilled Syringe.\n" ], "text": "" }

Step 2: Collect your supplies and wash your hands

{ "type": "p", "children": [], "text": "\nStep 2: Collect your supplies and wash your hands\n" }

{ "type": "ul", "children": [ "Find a well-lit area and a clean, flat surface like a table and collect all the supplies you will need to give yourself or to receive an injection.\n", "Wash your hands with soap and water.\n" ], "text": "" }

Step 3: Check your Plegridy Prefilled Syringe

{ "type": "p", "children": [], "text": "\nStep 3: Check your Plegridy Prefilled Syringe\n" }

<div class="scrollingtable"><table class="Noautorules" width="100%"> <col align="left" width="47.200%"/> <col align="left" width="52.800%"/> <tbody class="Headless"> <tr> <td align="left" class="Botrule Lrule Rrule Toprule" valign="top"> Check the expiration date printed on your Plegridy Prefilled Syringe (See <a href="#f31">Figure F</a>).<br/> <ul class="Disc"> <li> <span class="Bold">Do not</span> use Plegridy Prefilled Syringe past the expiration date. </li> </ul> </td><td align="center" class="Botrule Rrule Toprule" rowspan="2" valign="top"> <br/> <a name="f31"></a><img alt="Figure F and G " src="/dailymed/image.cfm?name=ple00-0024-31.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"> <ul class="Disc"> <li>Check that your Plegridy medicine is clear and colorless (See <a href="#f31">Figure G</a>).<ul class="Circle"> <li> <span class="Bold">Do not</span> use Plegridy Prefilled Syringe if the liquid is colored, cloudy, or has floating particles in it. </li> <li>You might see air bubbles in your Plegridy medicine. This is normal and will not affect your dose. </li> </ul> </li> </ul> </td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table class=\"Noautorules\" width=\"100%\">\n<col align=\"left\" width=\"47.200%\"/>\n<col align=\"left\" width=\"52.800%\"/>\n<tbody class=\"Headless\">\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule Toprule\" valign=\"top\"> Check the expiration date printed on your Plegridy Prefilled Syringe (See <a href=\"#f31\">Figure F</a>).<br/>\n<ul class=\"Disc\">\n<li>\n<span class=\"Bold\">Do not</span> use Plegridy Prefilled Syringe past the expiration date.\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule Toprule\" rowspan=\"2\" valign=\"top\">\n<br/>\n<a name=\"f31\"></a><img alt=\"Figure F and G\n\" src=\"/dailymed/image.cfm?name=ple00-0024-31.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>Check that your Plegridy medicine is clear and colorless (See <a href=\"#f31\">Figure G</a>).<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">Do not</span> use Plegridy Prefilled Syringe if the liquid is colored, cloudy, or has floating particles in it.\n</li>\n<li>You might see air bubbles in your Plegridy medicine. This is normal and will not affect your dose.\n</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table></div>" }

<div class="scrollingtable"><table class="Noautorules" width="100%"> <col align="left" width="47.200%"/> <col align="left" width="52.800%"/> <tbody class="Headless"> <tr> <td align="left" class="Botrule" colspan="2" valign="top"><span class="Bold">Step 4: Choose and clean your injection site</span></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"> <ul class="Disc"> <li>Plegridy Prefilled Syringe is for use under the skin only (subcutaneous). </li> <li>Plegridy Prefilled Syringe should be injected into your thigh, stomach area (abdomen) or the back of your upper arm (See <a href="#f32">Figure H</a>).<ul class="Circle"> <li> <span class="Bold">Do not</span> inject directly into your belly button. </li> <li> <span class="Bold">Do not</span> inject into an area of your body where the skin is irritated, reddened, bruised, infected or scarred. </li> </ul> </li> <li> <span class="Bold">Change (rotate) your injection site</span> for each injection. <span class="Bold">Do not</span> use the same injection site for each injection. </li> <li>Choose an injection site and wipe your skin with an alcohol wipe.<ul class="Circle"> <li>Do not touch this area again before giving your injection. </li> </ul> </li> <li>Let your injection site dry on its own before injecting the dose. </li> <li> <span class="Bold">Do not</span> take off the Plegridy Prefilled Syringe needle cover until you are ready to inject. </li> </ul> </td><td align="center" class="Botrule Rrule" valign="top"><a name="f32"></a><img alt="Figure H " src="/dailymed/image.cfm?name=ple00-0024-32.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule" colspan="2" valign="top"> <br/> <span class="Bold">Giving Your Injection:</span> <br/> <br/> <span class="Bold">Step 5: Remove the Plegridy Prefilled Syringe needle cover</span></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"> <ul class="Disc"> <li>With 1 hand, hold your Plegridy Prefilled Syringe. With your other hand, firmly hold the needle cover and pull the needle cover straight off the needle (See <a href="#f33">Figure I</a>).<ul class="Disc"> <li> <span class="Bold">Be careful</span> when removing the needle cover to avoid getting a needle stick injury. </li> <li> <span class="Bold">Do not</span> touch the needle. </li> <li> <span class="Bold">Important: Do not</span> recap the Plegridy Prefilled Syringe. You could get a needle stick injury. </li> <li>Throw away the needle cover after your injection. </li> </ul> </li> </ul> </td><td align="center" class="Botrule Rrule" valign="top"><a name="f33"></a><img alt="Figure I " src="/dailymed/image.cfm?name=ple00-0024-33.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule" colspan="2" valign="top"> <br/> <span class="Bold">Step 6: Gently pinch the injection site</span></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"> <ul class="Disc"> <li>With 1 hand, use your thumb and first finger and pinch the skin around your cleaned injection site (See <a href="#f34">Figure J</a>).<br/> <br/> </li> </ul> </td><td align="center" class="Botrule Rrule" valign="top"> <br/> <a name="f34"></a><img alt="Figure J " src="/dailymed/image.cfm?name=ple00-0024-34.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/><br/> </td> </tr> <tr> <td align="left" class="Botrule" colspan="2" valign="top"><span class="Bold">Step 7: Give your Plegridy Prefilled Syringe injection</span></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"> <ul class="Disc"> <li>With your other hand, hold your Plegridy Prefilled Syringe like a pencil. <span class="Bold">Use a quick dart-like motion and insert the needle at a 90° angle into your skin (See <a href="#f35">Figure K</a>).</span> </li> <li>After the needle is in, let go of your skin.<br/> </li> </ul> </td><td align="center" class="Botrule Lrule Rrule" valign="top"> <br/> <a name="f35"></a><img alt="Figure K " src="/dailymed/image.cfm?name=ple00-0024-35.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"> <ul class="Disc"> <li>Slowly push the plunger down until the syringe is empty (See <a href="#f36">Figure L</a>).<ul class="Circle"> <li> <span class="Bold">Do not</span> take your Plegridy Prefilled Syringe out of your injection site until you have slowly pushed the plunger all the way down.<br/> </li> </ul> </li> </ul> </td><td align="center" class="Botrule Lrule Rrule" valign="top"> <br/> <br/> <a name="f36"></a><img alt="Figure L " src="/dailymed/image.cfm?name=ple00-0024-36.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/><br/> </td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"> <ul class="Disc"> <li>Pull the needle straight out of your skin (See <a href="#f37">Figure M</a>).<ul class="Circle"> <li>If you see blood at your injection site, wipe it off with the gauze pad and apply an adhesive bandage. </li> </ul> </li> <li> <span class="Bold">Important: Do not</span> recap your Plegridy Prefilled Syringe. You could get a needle stick injury. </li> <li> <span class="Bold">Do not</span> reuse your Plegridy Prefilled Syringe.<br/> </li> </ul> </td><td align="center" class="Botrule Lrule Rrule" valign="top"> <br/> <br/> <a name="f37"></a><img alt="Figure M " src="/dailymed/image.cfm?name=ple00-0024-37.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table class=\"Noautorules\" width=\"100%\">\n<col align=\"left\" width=\"47.200%\"/>\n<col align=\"left\" width=\"52.800%\"/>\n<tbody class=\"Headless\">\n<tr>\n<td align=\"left\" class=\"Botrule\" colspan=\"2\" valign=\"top\"><span class=\"Bold\">Step 4: Choose and clean your injection site</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>Plegridy Prefilled Syringe is for use under the skin only (subcutaneous).\n</li>\n<li>Plegridy Prefilled Syringe should be injected into your thigh, stomach area (abdomen) or the back of your upper arm (See <a href=\"#f32\">Figure H</a>).<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">Do not</span> inject directly into your belly button.\n</li>\n<li>\n<span class=\"Bold\">Do not</span> inject into an area of your body where the skin is irritated, reddened, bruised, infected or scarred.\n</li>\n</ul>\n</li>\n<li>\n<span class=\"Bold\">Change (rotate) your injection site</span> for each injection. <span class=\"Bold\">Do not</span> use the same injection site for each injection.\n</li>\n<li>Choose an injection site and wipe your skin with an alcohol wipe.<ul class=\"Circle\">\n<li>Do not touch this area again before giving your injection.\n</li>\n</ul>\n</li>\n<li>Let your injection site dry on its own before injecting the dose.\n</li>\n<li>\n<span class=\"Bold\">Do not</span> take off the Plegridy Prefilled Syringe needle cover until you are ready to inject.\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><a name=\"f32\"></a><img alt=\"Figure H\n\" src=\"/dailymed/image.cfm?name=ple00-0024-32.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule\" colspan=\"2\" valign=\"top\">\n<br/>\n<span class=\"Bold\">Giving Your Injection:</span>\n<br/>\n<br/>\n<span class=\"Bold\">Step 5: Remove the Plegridy Prefilled Syringe needle cover</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>With 1 hand, hold your Plegridy Prefilled Syringe. With your other hand, firmly hold the needle cover and pull the needle cover straight off the needle (See <a href=\"#f33\">Figure I</a>).<ul class=\"Disc\">\n<li>\n<span class=\"Bold\">Be careful</span> when removing the needle cover to avoid getting a needle stick injury.\n</li>\n<li>\n<span class=\"Bold\">Do not</span> touch the needle.\n</li>\n<li>\n<span class=\"Bold\">Important: Do not</span> recap the Plegridy Prefilled Syringe. You could get a needle stick injury.\n</li>\n<li>Throw away the needle cover after your injection.\n</li>\n</ul>\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><a name=\"f33\"></a><img alt=\"Figure I\n\" src=\"/dailymed/image.cfm?name=ple00-0024-33.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule\" colspan=\"2\" valign=\"top\">\n<br/>\n<span class=\"Bold\">Step 6: Gently pinch the injection site</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>With 1 hand, use your thumb and first finger and pinch the skin around your cleaned injection site (See <a href=\"#f34\">Figure J</a>).<br/>\n<br/>\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">\n<br/>\n<a name=\"f34\"></a><img alt=\"Figure J\n\" src=\"/dailymed/image.cfm?name=ple00-0024-34.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/><br/>\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule\" colspan=\"2\" valign=\"top\"><span class=\"Bold\">Step 7: Give your Plegridy Prefilled Syringe injection</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>With your other hand, hold your Plegridy Prefilled Syringe like a pencil. <span class=\"Bold\">Use a quick dart-like motion and insert the needle at a 90° angle into your skin (See <a href=\"#f35\">Figure K</a>).</span>\n</li>\n<li>After the needle is in, let go of your skin.<br/>\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<br/>\n<a name=\"f35\"></a><img alt=\"Figure K\n\" src=\"/dailymed/image.cfm?name=ple00-0024-35.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>Slowly push the plunger down until the syringe is empty (See <a href=\"#f36\">Figure L</a>).<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">Do not</span> take your Plegridy Prefilled Syringe out of your injection site until you have slowly pushed the plunger all the way down.<br/>\n</li>\n</ul>\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<br/>\n<br/>\n<a name=\"f36\"></a><img alt=\"Figure L\n\" src=\"/dailymed/image.cfm?name=ple00-0024-36.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/><br/>\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>Pull the needle straight out of your skin (See <a href=\"#f37\">Figure M</a>).<ul class=\"Circle\">\n<li>If you see blood at your injection site, wipe it off with the gauze pad and apply an adhesive bandage.\n</li>\n</ul>\n</li>\n<li>\n<span class=\"Bold\">Important: Do not</span> recap your Plegridy Prefilled Syringe. You could get a needle stick injury.\n</li>\n<li>\n<span class=\"Bold\">Do not</span> reuse your Plegridy Prefilled Syringe.<br/>\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<br/>\n<br/>\n<a name=\"f37\"></a><img alt=\"Figure M\n\" src=\"/dailymed/image.cfm?name=ple00-0024-37.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n</tbody>\n</table></div>" }

After Your Injection:

{ "type": "p", "children": [], "text": "\nAfter Your Injection:\n" }

Step 8: Disposing of your used Plegridy Prefilled Syringes

{ "type": "p", "children": [], "text": "\nStep 8: Disposing of your used Plegridy Prefilled Syringes\n" }

{ "type": "ul", "children": [ "Put your used Plegridy Prefilled Syringes in a FDA-cleared sharps disposal container right away after use. Do not throw away (dispose of) Plegridy Prefilled Syringes in your household trash.\n", "If you do not have a FDA-cleared sharps disposal container, you may use a household container that is:\nmade of a heavy-duty plastic,\n\ncan be closed with a tight-fitting, puncture-resistant lid, without sharps being able to come out,\n\nupright and stable during use,\n\nleak resistant, and\n\nproperly labeled to warn of hazardous waste inside the container.\n\n\n", "When your sharps disposal container is almost full, you will need to follow your community guidelines for the right way to dispose of your sharps disposal container. There may be state or local laws about how you should throw away used needles and syringes. For more information about safe sharps disposal, and for specific information about sharps disposal in the state that you live in, go to the FDA's website at: http://www.fda.gov/safesharpsdisposal.\n", "\nDo not dispose of your used sharps disposal container in your household trash unless your community guidelines permit this. Do not recycle your used sharps disposal container.\n" ], "text": "" }

Step 9: Check your injection site

{ "type": "p", "children": [], "text": "\nStep 9: Check your injection site\n" }

{ "type": "ul", "children": [ "Plegridy may commonly cause redness, pain or swelling of your skin at the injection site.\n", "After 2 hours check your injection site for redness, swelling or tenderness.\n", "Call your healthcare provider right away if your injection site becomes swollen and painful or the area looks infected and does not heal within a few days.\n" ], "text": "" }

Questions?

{ "type": "p", "children": [], "text": "\nQuestions?\n" }

For product or service-related questions, call 1-800-456-2255 or go to www.plegridy.com.

{ "type": "p", "children": [], "text": "For product or service-related questions, call 1-800-456-2255 or go to www.plegridy.com.\n" }

This Instructions for Use has been approved by the U.S. Food and Drug Administration.

{ "type": "p", "children": [], "text": "This Instructions for Use has been approved by the U.S. Food and Drug Administration.\n" }

Manufactured by: Biogen Inc., Cambridge, MA 02142, U.S. License # 1697

{ "type": "p", "children": [], "text": "Manufactured by: Biogen Inc., Cambridge, MA 02142, U.S. License # 1697\n" }

©2013-2020 Biogen. All rights reserved. 1-800-456-2255

{ "type": "p", "children": [], "text": "©2013-2020 Biogen. All rights reserved. 1-800-456-2255\n" }

Issued: 03/2020

{ "type": "p", "children": [], "text": "Issued: 03/2020\n" }

43840-05

{ "type": "p", "children": [], "text": "43840-05\n" }

INSTRUCTIONS FOR USE

{ "type": "p", "children": [], "text": "\nINSTRUCTIONS FOR USE\n" }

PLEGRIDY® (PLEGG-rih-dee)

{ "type": "p", "children": [], "text": "\nPLEGRIDY®\n(PLEGG-rih-dee)\n" }

(peginterferon beta-1a) injection, for Subcutaneous Use

{ "type": "p", "children": [], "text": "\n(peginterferon beta-1a) injection, for Subcutaneous Use\n" }

Single-Dose Prefilled Syringe

{ "type": "p", "children": [], "text": "\nSingle-Dose Prefilled Syringe\n" }

125 mcg

{ "type": "p", "children": [], "text": "\n125 mcg\n" }

How to Inject your Plegridy Prefilled Syringe

{ "type": "p", "children": [], "text": "\nHow to Inject your Plegridy Prefilled Syringe\n" }

Read this Instructions for Use before you start using Plegridy and each time you get a refill of your prescription. There may be new information. This information does not take the place of talking to your healthcare provider about your medical condition or your treatment.

{ "type": "p", "children": [], "text": "Read this Instructions for Use before you start using Plegridy and each time you get a refill of your prescription. There may be new information. This information does not take the place of talking to your healthcare provider about your medical condition or your treatment.\n" }

Important Information

{ "type": "p", "children": [], "text": "\nImportant Information\n" }

Follow this Instructions for Use for the Plegridy prefilled syringe for subcutaneous use (under the skin).  There is a different Instructions for Use for the Plegridy prefilled syringe for intramuscular use (into the muscle).

{ "type": "p", "children": [], "text": "Follow this Instructions for Use for the Plegridy prefilled syringe for subcutaneous use (under the skin).  There is a different Instructions for Use for the Plegridy prefilled syringe for intramuscular use (into the muscle).\n" }

Note:

{ "type": "p", "children": [], "text": "\nNote:\n" }

{ "type": "ul", "children": [ "\nBefore you use your Plegridy Prefilled Syringe for the first time, your healthcare provider should show you or your caregiver how to prepare and inject your Plegridy Prefilled Syringe the right way.\n", "If you experience difficulty or have questions, call 1-800-456-2255.\n", "Plegridy Prefilled Syringe is for use under the skin only (subcutaneous).\n", "\nEach Plegridy Prefilled Syringe can be used 1 time only. Do not share your Plegridy Prefilled Syringe with anyone else. By sharing the needle, you may give an infection to them or get an infection from them.\n", "\nTake your Plegridy Prefilled Syringe out of the refrigerator and let it come to room temperature for at least 30 minutes before your injection.\n", "\nDo not use more than 1 Plegridy Prefilled Syringe every 14 days.\n", "\nDo not use your Plegridy Prefilled Syringe if it has been dropped or is visibly damaged.\n" ], "text": "" }

How should I store Plegridy?

{ "type": "p", "children": [], "text": "\nHow should I store Plegridy?\n" }

{ "type": "ul", "children": [ "Store Plegridy in the refrigerator between 36°F to 46°F (2°C to 8°C).\n", "If a refrigerator is not available, PLEGRIDY may be stored at room temperature up to 77°F (25°C) for up to 30 days in total.\n", "Keep Plegridy in the original carton to protect it from light.\n", "\nDo not freeze Plegridy.\n", "\nKeep Plegridy Prefilled Syringes, needles, and all medicines out of the reach of children.\n" ], "text": "" }

Supplies needed for your Plegridy Prefilled Syringe injection:

{ "type": "p", "children": [], "text": "\nSupplies needed for your Plegridy Prefilled Syringe injection:\n" }

{ "type": "ul", "children": [ "1 Plegridy 125 mcg Prefilled Syringe (See Figure A)\n" ], "text": "" }

Additional supplies which are not included in the pack (See Figure B):

{ "type": "p", "children": [], "text": "Additional supplies which are not included in the pack (See Figure B):\n" }

{ "type": "ul", "children": [ "alcohol wipe\n", "gauze pad\n", "adhesive bandage\n", "1 sharps container for throwing away used needles and Plegridy Prefilled Syringes. See “Disposing of your used Plegridy Prefilled Syringes” at the end of these instructions.\n", "a well-lit area and a clean, flat surface to work on, like a table\n" ], "text": "" }

Preparing for your injection:

{ "type": "p", "children": [], "text": "\nPreparing for your injection:\n" }

Step 1: Take your Plegridy Prefilled Syringe out of the refrigerator and let it come to room temperature for at least 30 minutes.

{ "type": "p", "children": [], "text": "\nStep 1: Take your Plegridy Prefilled Syringe out of the refrigerator and let it come to room temperature for at least 30 minutes.\n" }

{ "type": "ul", "children": [ "\nDo not use external heat sources such as hot water to warm your Plegridy Prefilled Syringe.\n" ], "text": "" }

Step 2: Collect your supplies and wash your hands

{ "type": "p", "children": [], "text": "\nStep 2: Collect your supplies and wash your hands\n" }

{ "type": "ul", "children": [ "Find a well-lit area and a clean, flat surface like a table and collect all the supplies you will need to give yourself or to receive an injection.\n", "Wash your hands with soap and water.\n" ], "text": "" }

Step 3: Check your Plegridy Prefilled Syringe

{ "type": "p", "children": [], "text": "\nStep 3: Check your Plegridy Prefilled Syringe\n" }

<div class="scrollingtable"><table width="100%"> <col align="left" width="50.000%"/> <col align="left" width="50.000%"/> <tbody class="Headless"> <tr class="First"> <td align="left" class="Botrule Lrule Rrule Toprule" valign="top"> <ul class="Disc"> <li>Check the expiration date printed on your Plegridy Prefilled Syringe (See <a href="#f40">Figure C</a>).<ul class="Circle"> <li> <span class="Bold">Do not</span> use Plegridy Prefilled Syringe past the expiration date. </li> </ul> </li> </ul> </td><td align="center" class="Botrule Rrule Toprule" rowspan="2" valign="top"> <br/> <a name="f40"></a><img alt="Figures C and D " src="/dailymed/image.cfm?name=ple00-0024-40.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr class="Last"> <td align="left" class="Botrule Lrule Rrule" valign="top"> <ul class="Disc"> <li>Check that your Plegridy medicine is clear and colorless (See <a href="#f40">Figure D</a>).<ul class="Circle"> <li> <span class="Bold">Do not</span> use Plegridy Prefilled Syringe if the liquid is colored, cloudy, or has floating particles in it. </li> <li>You might see air bubbles in your Plegridy medicine. This is normal and will not affect your dose. </li> </ul> </li> </ul> </td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table width=\"100%\">\n<col align=\"left\" width=\"50.000%\"/>\n<col align=\"left\" width=\"50.000%\"/>\n<tbody class=\"Headless\">\n<tr class=\"First\">\n<td align=\"left\" class=\"Botrule Lrule Rrule Toprule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>Check the expiration date printed on your Plegridy Prefilled Syringe (See <a href=\"#f40\">Figure C</a>).<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">Do not</span> use Plegridy Prefilled Syringe past the expiration date.\n</li>\n</ul>\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule Toprule\" rowspan=\"2\" valign=\"top\">\n<br/>\n<a name=\"f40\"></a><img alt=\"Figures C and D\n\" src=\"/dailymed/image.cfm?name=ple00-0024-40.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr class=\"Last\">\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>Check that your Plegridy medicine is clear and colorless (See <a href=\"#f40\">Figure D</a>).<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">Do not</span> use Plegridy Prefilled Syringe if the liquid is colored, cloudy, or has floating particles in it.\n</li>\n<li>You might see air bubbles in your Plegridy medicine. This is normal and will not affect your dose.\n</li>\n</ul>\n</li>\n</ul>\n</td>\n</tr>\n</tbody>\n</table></div>" }

<div class="scrollingtable"><table class="Noautorules" width="100%"> <col align="left" width="32.867%"/> <col align="left" width="3.033%"/> <col align="left" width="64.100%"/> <tbody class="Headless"> <tr> <td align="left" class="Botrule" colspan="3" valign="top"><span class="Bold">Step 4: Choose and clean your injection site</span></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" colspan="2" valign="top"> <ul class="Disc"> <li>Plegridy Prefilled Syringe is for use under the skin only (subcutaneous). </li> <li>Plegridy Prefilled Syringe should be injected into your thigh, abdomen or the back of your upper arm (See <a href="#f41">Figure E</a>).<ul class="Circle"> <li> <span class="Bold">Do not</span> inject directly into your belly button. </li> <li> <span class="Bold">Do not</span> inject into an area of your body where the skin is irritated, reddened, bruised, infected or scarred. </li> </ul> </li> <li> <span class="Bold">Change (rotate) your injection site</span> for each injection. <span class="Bold">Do not</span> use the same injection site for each injection. </li> <li>Choose an injection site and wipe your skin with an alcohol wipe. </li> <li>Do not touch this area again before giving your injection. </li> <li>Let your injection site dry on its own before injecting your dose. </li> <li> <span class="Bold">Do not</span> take off the Plegridy Prefilled Syringe needle cover until you are ready to inject. </li> </ul> </td><td align="center" class="Botrule Rrule" valign="top"> <br/> <a name="f41"></a><img alt="Figure E " src="/dailymed/image.cfm?name=ple00-0024-41.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule" colspan="3" valign="top"><span class="Bold">Giving Your Injection:</span> <br/> <span class="Bold">Step 5: Remove the Plegridy Prefilled Syringe needle cover</span></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"> <ul class="Disc"> <li>With 1 hand, hold your Plegridy Prefilled Syringe. With your other hand, firmly hold the needle cover and pull the needle cover straight off the needle (See <a href="#f42">Figure F</a>).<ul class="Circle"> <li> <span class="Bold">Be careful</span> when removing the needle cover to avoid getting a needle stick injury. </li> <li> <span class="Bold">Do not</span> touch the needle. </li> <li> <span class="Bold">Important: Do not</span> recap the Plegridy Prefilled Syringe. You could get a needle stick injury. </li> <li>Throw away the needle cover after your injection.<br/> </li> </ul> </li> </ul> </td><td align="center" class="Botrule Rrule" colspan="2" valign="top"> <br/> <br/> <a name="f42"></a><img alt="Figure F " src="/dailymed/image.cfm?name=ple00-0024-42.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule" colspan="3" valign="top"><span class="Bold">Step 6: Gently pinch the injection site</span></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"> <ul class="Disc"> <li>With 1 hand, use your thumb and first finger and pinch the skin around your cleaned injection site (See <a href="#f43">Figure G</a>).<br/> </li> </ul> </td><td align="center" class="Botrule Rrule" colspan="2" valign="top"> <br/> <a name="f43"></a><img alt="Figure G " src="/dailymed/image.cfm?name=ple00-0024-43.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/><br/> </td> </tr> <tr> <td align="left" class="Botrule" colspan="3" valign="top"> <br/> <br/> <br/> <br/> <br/> <br/> <span class="Bold">Step 7: Give your Plegridy Prefilled Syringe injection</span></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"> <ul class="Disc"> <li>With your other hand, hold your Plegridy Prefilled Syringe like a pencil. <span class="Bold">Use a quick dart-like motion and insert the needle at a 90° angle into your skin (See <a href="#f44">Figure H</a>).</span> </li> <li>After the needle is in, let go of your skin. </li> </ul> </td><td align="center" class="Botrule Rrule" colspan="2" valign="top"> <br/> <a name="f44"></a><img alt="Figure H " src="/dailymed/image.cfm?name=ple00-0024-44.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"> <ul class="Disc"> <li>Slowly push the plunger down until the syringe is empty (See <a href="#f45">Figure I</a>).<ul class="Circle"> <li> <span class="Bold">Do not</span> take your Plegridy Prefilled Syringe out of your injection site until you have slowly pushed the plunger all the way down. </li> </ul> </li> </ul> </td><td align="center" class="Botrule Rrule" colspan="2" valign="top"> <br/> <br/> <a name="f45"></a><img alt="Figure I " src="/dailymed/image.cfm?name=ple00-0024-45.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/><br/> </td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"> <ul class="Disc"> <li>Pull the needle straight out of your skin (See <a href="#f46">Figure J</a>).<ul class="Circle"> <li>If you see blood at your injection site, wipe it off with gauze and apply an adhesive bandage. </li> </ul> </li> <li> <span class="Bold">Important: Do not</span> recap your Plegridy Prefilled Syringe. You could get a needle stick injury. </li> <li> <span class="Bold">Do not</span> reuse your Plegridy Prefilled Syringe.<br/> </li> </ul> </td><td align="center" class="Botrule Rrule" colspan="2" valign="top"> <br/> <br/> <a name="f46"></a><img alt="Figure J " src="/dailymed/image.cfm?name=ple00-0024-46.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table class=\"Noautorules\" width=\"100%\">\n<col align=\"left\" width=\"32.867%\"/>\n<col align=\"left\" width=\"3.033%\"/>\n<col align=\"left\" width=\"64.100%\"/>\n<tbody class=\"Headless\">\n<tr>\n<td align=\"left\" class=\"Botrule\" colspan=\"3\" valign=\"top\"><span class=\"Bold\">Step 4: Choose and clean your injection site</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" colspan=\"2\" valign=\"top\">\n<ul class=\"Disc\">\n<li>Plegridy Prefilled Syringe is for use under the skin only (subcutaneous).\n</li>\n<li>Plegridy Prefilled Syringe should be injected into your thigh, abdomen or the back of your upper arm (See <a href=\"#f41\">Figure E</a>).<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">Do not</span> inject directly into your belly button.\n</li>\n<li>\n<span class=\"Bold\">Do not</span> inject into an area of your body where the skin is irritated, reddened, bruised, infected or scarred.\n</li>\n</ul>\n</li>\n<li>\n<span class=\"Bold\">Change (rotate) your injection site</span> for each injection. <span class=\"Bold\">Do not</span> use the same injection site for each injection.\n</li>\n<li>Choose an injection site and wipe your skin with an alcohol wipe.\n</li>\n<li>Do not touch this area again before giving your injection.\n</li>\n<li>Let your injection site dry on its own before injecting your dose.\n</li>\n<li>\n<span class=\"Bold\">Do not</span> take off the Plegridy Prefilled Syringe needle cover until you are ready to inject.\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">\n<br/>\n<a name=\"f41\"></a><img alt=\"Figure E\n\" src=\"/dailymed/image.cfm?name=ple00-0024-41.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule\" colspan=\"3\" valign=\"top\"><span class=\"Bold\">Giving Your Injection:</span>\n<br/>\n<span class=\"Bold\">Step 5: Remove the Plegridy Prefilled Syringe needle cover</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>With 1 hand, hold your Plegridy Prefilled Syringe. With your other hand, firmly hold the needle cover and pull the needle cover straight off the needle (See <a href=\"#f42\">Figure F</a>).<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">Be careful</span> when removing the needle cover to avoid getting a needle stick injury.\n</li>\n<li>\n<span class=\"Bold\">Do not</span> touch the needle.\n</li>\n<li>\n<span class=\"Bold\">Important: Do not</span> recap the Plegridy Prefilled Syringe. You could get a needle stick injury.\n</li>\n<li>Throw away the needle cover after your injection.<br/>\n</li>\n</ul>\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule\" colspan=\"2\" valign=\"top\">\n<br/>\n<br/>\n<a name=\"f42\"></a><img alt=\"Figure F\n\" src=\"/dailymed/image.cfm?name=ple00-0024-42.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule\" colspan=\"3\" valign=\"top\"><span class=\"Bold\">Step 6: Gently pinch the injection site</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>With 1 hand, use your thumb and first finger and pinch the skin around your cleaned injection site (See <a href=\"#f43\">Figure G</a>).<br/>\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule\" colspan=\"2\" valign=\"top\">\n<br/>\n<a name=\"f43\"></a><img alt=\"Figure G\n\" src=\"/dailymed/image.cfm?name=ple00-0024-43.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/><br/>\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule\" colspan=\"3\" valign=\"top\">\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<span class=\"Bold\">Step 7: Give your Plegridy Prefilled Syringe injection</span></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>With your other hand, hold your Plegridy Prefilled Syringe like a pencil. <span class=\"Bold\">Use a quick dart-like motion and insert the needle at a 90° angle into your skin (See <a href=\"#f44\">Figure H</a>).</span>\n</li>\n<li>After the needle is in, let go of your skin.\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule\" colspan=\"2\" valign=\"top\">\n<br/>\n<a name=\"f44\"></a><img alt=\"Figure H\n\" src=\"/dailymed/image.cfm?name=ple00-0024-44.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>Slowly push the plunger down until the syringe is empty (See <a href=\"#f45\">Figure I</a>).<ul class=\"Circle\">\n<li>\n<span class=\"Bold\">Do not</span> take your Plegridy Prefilled Syringe out of your injection site until you have slowly pushed the plunger all the way down.\n</li>\n</ul>\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule\" colspan=\"2\" valign=\"top\">\n<br/>\n<br/>\n<a name=\"f45\"></a><img alt=\"Figure I\n\" src=\"/dailymed/image.cfm?name=ple00-0024-45.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/><br/>\n</td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<ul class=\"Disc\">\n<li>Pull the needle straight out of your skin (See <a href=\"#f46\">Figure J</a>).<ul class=\"Circle\">\n<li>If you see blood at your injection site, wipe it off with gauze and apply an adhesive bandage.\n</li>\n</ul>\n</li>\n<li>\n<span class=\"Bold\">Important: Do not</span> recap your Plegridy Prefilled Syringe. You could get a needle stick injury.\n</li>\n<li>\n<span class=\"Bold\">Do not</span> reuse your Plegridy Prefilled Syringe.<br/>\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule\" colspan=\"2\" valign=\"top\">\n<br/>\n<br/>\n<a name=\"f46\"></a><img alt=\"Figure J\n\" src=\"/dailymed/image.cfm?name=ple00-0024-46.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n</tbody>\n</table></div>" }

After Your Injection:

{ "type": "p", "children": [], "text": "\nAfter Your Injection:\n" }

Step 8: Disposing of your used Plegridy Prefilled Syringes

{ "type": "p", "children": [], "text": "\nStep 8: Disposing of your used Plegridy Prefilled Syringes\n" }

{ "type": "ul", "children": [ "Put your used Plegridy Prefilled Syringes in an FDA-cleared sharps disposal container right away after use. Do not throw away (dispose of) Plegridy Prefilled Syringes in your household trash.\n", "If you do not have a FDA-cleared sharps disposal container, you may use a household container that is:\nmade of a heavy-duty plastic,\n\ncan be closed with a tight-fitting, puncture-resistant lid, without sharps being able to come out,\n\nupright and stable during use,\n\nleak resistant, and\n\nproperly labeled to warn of hazardous waste inside the container.\n\n\n", "When your sharps disposal container is almost full, you will need to follow your community guidelines for the right way to dispose of your sharps disposal container. There may be state or local laws about how you should throw away used needles and syringes. For more information about safe sharps disposal, and for specific information about sharps disposal in the state that you live in, go to the FDA's website at: http://www.fda.gov/safesharpsdisposal.\n", "\nDo not dispose of your used sharps disposal container in your household trash unless your community guidelines permit this. Do not recycle your used sharps disposal container.\n" ], "text": "" }

Step 9: Check your injection site

{ "type": "p", "children": [], "text": "\nStep 9: Check your injection site\n" }

{ "type": "ul", "children": [ "Plegridy may commonly cause redness, pain or swelling of your skin at the injection site.\n", "After 2 hours, check your injection site for redness, swelling or tenderness.\n", "Call your healthcare provider right away if your injection site becomes swollen and painful or the area looks infected and does not heal within a few days.\n" ], "text": "" }

Questions?

{ "type": "p", "children": [], "text": "\nQuestions?\n" }

For product or service-related questions, call 1-800-456-2255 or go to www.plegridy.com.

{ "type": "p", "children": [], "text": "For product or service-related questions, call 1-800-456-2255 or go to www.plegridy.com.\n" }

This Instructions for Use has been approved by the U.S. Food and Drug Administration.

{ "type": "p", "children": [], "text": "This Instructions for Use has been approved by the U.S. Food and Drug Administration.\n" }

Manufactured by: Biogen Inc., Cambridge, MA 02142, U.S. License # 1697©2013-2021 Biogen. All rights reserved. 1-800-456-2255

{ "type": "p", "children": [], "text": "Manufactured by: Biogen Inc., Cambridge, MA 02142, U.S. License # 1697©2013-2021 Biogen. All rights reserved. 1-800-456-2255\n" }

Issued: 1/202143654-04

{ "type": "p", "children": [], "text": "Issued: 1/202143654-04\n" }

Instructions for Use

{ "type": "p", "children": [], "text": "\nInstructions for Use\n" }

PLEGRIDY® (PLEGG-rih-dee)

{ "type": "p", "children": [], "text": "\nPLEGRIDY®\n(PLEGG-rih-dee)\n" }

(peginterferon beta-1a)

{ "type": "p", "children": [], "text": "\n(peginterferon beta-1a)\n" }

injection for intramuscular use

{ "type": "p", "children": [], "text": "\ninjection for intramuscular use\n" }

Single-Dose Prefilled Syringe

{ "type": "p", "children": [], "text": "\nSingle-Dose Prefilled Syringe\n" }

Read this Instructions for Use before you start using Plegridy and each time you get a refill. There may be new information. This information does not take the place of talking to your healthcare provider about your medical condition or your treatment.

{ "type": "p", "children": [], "text": "Read this Instructions for Use before you start using Plegridy and each time you get a refill. There may be new information. This information does not take the place of talking to your healthcare provider about your medical condition or your treatment.\n" }

Important information:

{ "type": "p", "children": [], "text": "\nImportant information:\n" }

{ "type": "ul", "children": [ "The tip of the cap of the Plegridy prefilled syringe is made of natural rubber latex. Tell your healthcare provider if you are allergic to rubber or latex.\n", "Follow this Instructions for Use for the Plegridy prefilled syringe for intramuscular use (into the muscle). There is a different Instructions for Use for the Plegridy prefilled syringe for subcutaneous use (under the skin).\n" ], "text": "" }

Note:

{ "type": "p", "children": [], "text": "\nNote:\n" }

{ "type": "ul", "children": [ "Before you use your Plegridy prefilled syringe for the first time, your healthcare provider should show you or your caregiver how to prepare and inject your Plegridy prefilled syringe the right way.\n", "Each Plegridy prefilled syringe can be used 1 time only. Do not share your Plegridy prefilled syringe with anyone else. By sharing the needle, you may give an infection to them or get an infection from them.\n", "Do not use more than 1 Plegridy prefilled syringe every 14 days.\n" ], "text": "" }

How should I store Plegridy?

{ "type": "p", "children": [], "text": "\nHow should I store Plegridy?\n" }

{ "type": "ul", "children": [ "Store Plegridy in the refrigerator between 36°F to 46°F (2°C to 8°C).\n", "If a refrigerator is not available, Plegridy may be stored at room temperature up to 77°F (25°C) for a total of 30 days.\n", "You can store your Plegridy prefilled syringes at room temperature and then put it back in the refrigerator.\n", "\nDo not freeze Plegridy. Do not use Plegridy that has been frozen.\n", "Store Plegridy in the original carton to protect it from light.\n" ], "text": "" }

Keep the Plegridy prefilled syringe and all medicines out of the reach of children.

{ "type": "p", "children": [], "text": "\nKeep the Plegridy prefilled syringe and all medicines out of the reach of children.\n" }

Supplies you will need for the Plegridy injection:

{ "type": "p", "children": [], "text": "\nSupplies you will need for the Plegridy injection:\n" }

{ "type": "ul", "children": [ "1 Plegridy Administration Dose Pack that contains:\n1 Plegridy prefilled syringe\n\n23 gauge, 1¼ inch long sterile needle\n\n\n" ], "text": "" }

Additional supplies not included in your Plegridy Administration Dose pack:

{ "type": "p", "children": [], "text": "\nAdditional supplies not included in your Plegridy Administration Dose pack:\n" }

{ "type": "ul", "children": [ "1 alcohol wipe\n", "1 gauze pad\n", "1 adhesive bandage\n", "a sharps disposal container for throwing away used syringes and needles. See “After the Plegridy injection” at the end of these instructions.\n\n" ], "text": "" }

Preparing the dose of Plegridy:

{ "type": "p", "children": [], "text": "\nPreparing the dose of Plegridy:\n" }

{ "type": "ul", "children": [ "Find a well-lit, clean, flat work surface like a table and collect all the supplies you will need to give yourself or receive an injection.\n", "Take 1 Plegridy Administration Dose Pack out of the refrigerator and let it come to room temperature for about 30 minutes. Do not use external heat sources such as hot water to warm the Plegridy prefilled syringe.\n", "Check the expiration date printed on the Plegridy prefilled syringe, Plegridy Administration Dose Pack, and the outer carton. Do not use the Plegridy prefilled syringe past the expiration date.\n", "Wash your hands with soap and water.\n" ], "text": "" }

Identifying parts of the Plegridy prefilled syringe (See Figure A).

{ "type": "p", "children": [], "text": "\nIdentifying parts of the Plegridy prefilled syringe (See Figure A).\n" }

Preparing the Plegridy injection:

{ "type": "p", "children": [], "text": "\nPreparing the Plegridy injection:\n" }

<div class="scrollingtable"><table width="100%"> <col align="left" width="50.000%"/> <col align="left" width="50.000%"/> <tbody class="Headless"> <tr class="First"> <td align="left" class="Botrule Lrule Rrule Toprule" valign="top"><span class="Bold">Step 1:</span> Check the Plegridy prefilled syringe (See <a href="#f49">Figure A</a>):<br/> <ul class="Disc"> <li>The syringe should not have any cracks or damage. </li> <li>Check that the cap is intact and has not been removed. </li> <li>Plegridy should look slightly clear, colorless to slightly yellow, and should not have any particles in it. </li> </ul> <span class="Bold">Do not</span> use the Plegridy prefilled syringe if:<br/> <ul class="Disc"> <li>the syringe is cracked or damaged. </li> <li>the solution is cloudy, colored other than slightly yellow, or has lumps or particles in it. </li> <li> the cap has been removed or is not tightly attached.<br/> </li> </ul>If you cannot use that syringe, you will need to get a new syringe. Contact Biogen at 1-800-456-2255. </td><td align="center" class="Botrule Rrule Toprule" valign="top"> <br/> <br/> <a name="f49"></a><img alt="Figure A " src="/dailymed/image.cfm?name=ple00-0024-49.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Step 2:</span> With 1 hand, hold the Plegridy prefilled syringe right under the cap and with the cap pointing up (See <a href="#f50">Figure B</a>).<br/> <ul class="Disc"> <li>Make sure you are holding the Plegridy prefilled syringe by the ridged part, directly under the cap.<br/> </li> </ul> </td><td align="center" class="Botrule Rrule" valign="top"> <br/> <a name="f50"></a><img alt="Figure B " src="/dailymed/image.cfm?name=ple00-0024-50.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Step 3:</span> With the other hand, grasp the cap and bend it at a 90º angle until the cap snaps off (See <a href="#f51">Figure C</a> and <a href="#f52">Figure D</a>). </td><td align="center" class="Botrule Rrule" valign="top"> <br/> <a name="f51"></a><img alt="Figure C " src="/dailymed/image.cfm?name=ple00-0024-51.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/><br/> <br/> <br/> <a name="f52"></a><img alt="Figure D " src="/dailymed/image.cfm?name=ple00-0024-52.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Step 4:</span> Open the sterile needle package and take out the covered needle. Hold the Plegridy prefilled syringe with the glass syringe tip pointing up. Press the needle on the Plegridy prefilled syringe glass tip (See <a href="#f53">Figure E</a>).<br/> </td><td align="center" class="Botrule Rrule" valign="top"> <br/> <br/> <br/> <a name="f53"></a><img alt="Figure E " src="/dailymed/image.cfm?name=ple00-0024-53.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr class="Last"> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Step 5:</span> Gently turn the needle to the right (clockwise) until it is tight and firmly attached (See <a href="#f54">Figure F</a>).<br/> <ul class="Disc"> <li>If the needle is not firmly attached, it may leak and you may not get your full dose of Plegridy. </li> <li> <span class="Bold">Do not</span> remove the protective cover from the needle. </li> </ul> </td><td align="center" class="Botrule Rrule" valign="top"><a name="f54"></a><img alt="Figure F " src="/dailymed/image.cfm?name=ple00-0024-54.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table width=\"100%\">\n<col align=\"left\" width=\"50.000%\"/>\n<col align=\"left\" width=\"50.000%\"/>\n<tbody class=\"Headless\">\n<tr class=\"First\">\n<td align=\"left\" class=\"Botrule Lrule Rrule Toprule\" valign=\"top\"><span class=\"Bold\">Step 1:</span> Check the Plegridy prefilled syringe (See <a href=\"#f49\">Figure A</a>):<br/>\n<ul class=\"Disc\">\n<li>The syringe should not have any cracks or damage.\n</li>\n<li>Check that the cap is intact and has not been removed.\n</li>\n<li>Plegridy should look slightly clear, colorless to slightly yellow, and should not have any particles in it.\n</li>\n</ul>\n<span class=\"Bold\">Do not</span> use the Plegridy prefilled syringe if:<br/>\n<ul class=\"Disc\">\n<li>the syringe is cracked or damaged.\n</li>\n<li>the solution is cloudy, colored other than slightly yellow, or has lumps or particles in it.\n</li>\n<li> the cap has been removed or is not tightly attached.<br/>\n</li>\n</ul>If you cannot use that syringe, you will need to get a new syringe. Contact Biogen at 1-800-456-2255.\n</td><td align=\"center\" class=\"Botrule Rrule Toprule\" valign=\"top\">\n<br/>\n<br/>\n<a name=\"f49\"></a><img alt=\"Figure A\n\" src=\"/dailymed/image.cfm?name=ple00-0024-49.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Step 2:</span> With 1 hand, hold the Plegridy prefilled syringe right under the cap and with the cap pointing up (See <a href=\"#f50\">Figure B</a>).<br/>\n<ul class=\"Disc\">\n<li>Make sure you are holding the Plegridy prefilled syringe by the ridged part, directly under the cap.<br/>\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">\n<br/>\n<a name=\"f50\"></a><img alt=\"Figure B\n\" src=\"/dailymed/image.cfm?name=ple00-0024-50.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Step 3:</span> With the other hand, grasp the cap and bend it at a 90º angle until the cap snaps off (See <a href=\"#f51\">Figure C</a> and <a href=\"#f52\">Figure D</a>).\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">\n<br/>\n<a name=\"f51\"></a><img alt=\"Figure C\n\" src=\"/dailymed/image.cfm?name=ple00-0024-51.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/><br/>\n<br/>\n<br/>\n<a name=\"f52\"></a><img alt=\"Figure D\n\" src=\"/dailymed/image.cfm?name=ple00-0024-52.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Step 4:</span> Open the sterile needle package and take out the covered needle. Hold the Plegridy prefilled syringe with the glass syringe tip pointing up. Press the needle on the Plegridy prefilled syringe glass tip (See <a href=\"#f53\">Figure E</a>).<br/>\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">\n<br/>\n<br/>\n<br/>\n<a name=\"f53\"></a><img alt=\"Figure E\n\" src=\"/dailymed/image.cfm?name=ple00-0024-53.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr class=\"Last\">\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Step 5:</span> Gently turn the needle to the right (clockwise) until it is tight and firmly attached (See <a href=\"#f54\">Figure F</a>).<br/>\n<ul class=\"Disc\">\n<li>If the needle is not firmly attached, it may leak and you may not get your full dose of Plegridy.\n</li>\n<li>\n<span class=\"Bold\">Do not</span> remove the protective cover from the needle.\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><a name=\"f54\"></a><img alt=\"Figure F\n\" src=\"/dailymed/image.cfm?name=ple00-0024-54.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n</tbody>\n</table></div>" }

Giving the Plegridy injection:

{ "type": "p", "children": [], "text": "\nGiving the Plegridy injection:\n" }

{ "type": "ul", "children": [ "Your healthcare provider should show you or a caregiver how to prepare and inject the dose of Plegridy before the Plegridy prefilled syringe is used for the first time. Your healthcare provider should watch you inject the dose of Plegridy the first time the Plegridy prefilled syringe is used.\n", "Inject your Plegridy exactly as your healthcare provider has shown you.\n", "Plegridy is injected into the muscle (intramuscularly).\n", "Plegridy should be injected into the thigh (See Figure G).\n", "Change (rotate) your injection sites for each dose. Do not use the same injection site for each injection.\n", "\nDo not inject into an area of the body where the skin is irritated, reddened, bruised, infected or scarred in any way.\n" ], "text": "" }

<div class="scrollingtable"><table width="100%"> <col align="left" width="49.400%"/> <col align="left" width="50.600%"/> <tbody class="Headless"> <tr class="First"> <td align="left" class="Botrule Lrule Rrule Toprule" valign="top"><span class="Bold">Step 6:</span> Choose your left or right thigh and wipe the skin with an alcohol wipe (See <a href="#f55">Figure G</a>). Let the injection site dry before injecting the dose.<br/> <ul class="Disc"> <li> <span class="Bold">Do not</span> touch this area again before giving the injection. </li> </ul> </td><td align="center" class="Botrule Rrule Toprule" valign="top"> <br/> <a name="f55"></a><img alt="Figure G " src="/dailymed/image.cfm?name=ple00-0024-55.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Step 7:</span> Pull the protective cover straight off the needle (See <a href="#f56">Figure H</a>). <span class="Bold">Do not</span> twist the cover off. </td><td align="center" class="Botrule Rrule" valign="top"> <br/> <a name="f56"></a><img alt="Figure H " src="/dailymed/image.cfm?name=ple00-0024-56.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Step 8:</span> With 1 hand, stretch the skin out around the injection site. With the other hand, hold the syringe like a pencil. Use a quick dart-like motion and insert the needle at a 90º angle, through the skin and into the muscle (See <a href="#f57">Figure I</a>). After the needle is in, let go of the skin. </td><td align="center" class="Botrule Rrule" valign="top"> <br/> <a name="f57"></a><img alt="Figure I " src="/dailymed/image.cfm?name=ple00-0024-57.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Step 9:</span> Slowly push the plunger down until the syringe is empty (See <a href="#f58">Figure J</a>).<br/> <br/> <br/> <br/> <br/> </td><td align="center" class="Botrule Rrule" valign="top"> <br/> <br/> <a name="f58"></a><img alt="Figure J " src="/dailymed/image.cfm?name=ple00-0024-58.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr class="Last"> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Step 10:</span> Pull the needle out of the skin (See <a href="#f59">Figure K</a>). Press down on the injection site with the gauze pad for a few seconds or rub gently in a circular motion.<br/> <ul class="Disc"> <li>If you see blood after you press the injection site for a few seconds, wipe it off with the gauze pad and apply an adhesive bandage. </li> </ul> </td><td align="center" class="Botrule Rrule" valign="top"> <br/> <a name="f59"></a><img alt="Figure K " src="/dailymed/image.cfm?name=ple00-0024-59.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table width=\"100%\">\n<col align=\"left\" width=\"49.400%\"/>\n<col align=\"left\" width=\"50.600%\"/>\n<tbody class=\"Headless\">\n<tr class=\"First\">\n<td align=\"left\" class=\"Botrule Lrule Rrule Toprule\" valign=\"top\"><span class=\"Bold\">Step 6:</span> Choose your left or right thigh and wipe the skin with an alcohol wipe (See <a href=\"#f55\">Figure G</a>). Let the injection site dry before injecting the dose.<br/>\n<ul class=\"Disc\">\n<li>\n<span class=\"Bold\">Do not</span> touch this area again before giving the injection.\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule Toprule\" valign=\"top\">\n<br/>\n<a name=\"f55\"></a><img alt=\"Figure G\n\" src=\"/dailymed/image.cfm?name=ple00-0024-55.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Step 7:</span> Pull the protective cover straight off the needle (See <a href=\"#f56\">Figure H</a>). <span class=\"Bold\">Do not</span> twist the cover off.\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">\n<br/>\n<a name=\"f56\"></a><img alt=\"Figure H\n\" src=\"/dailymed/image.cfm?name=ple00-0024-56.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Step 8:</span> With 1 hand, stretch the skin out around the injection site. With the other hand, hold the syringe like a pencil. Use a quick dart-like motion and insert the needle at a 90º angle, through the skin and into the muscle (See <a href=\"#f57\">Figure I</a>). After the needle is in, let go of the skin.\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">\n<br/>\n<a name=\"f57\"></a><img alt=\"Figure I\n\" src=\"/dailymed/image.cfm?name=ple00-0024-57.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Step 9:</span> Slowly push the plunger down until the syringe is empty (See <a href=\"#f58\">Figure J</a>).<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">\n<br/>\n<br/>\n<a name=\"f58\"></a><img alt=\"Figure J\n\" src=\"/dailymed/image.cfm?name=ple00-0024-58.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr class=\"Last\">\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Step 10:</span> Pull the needle out of the skin (See <a href=\"#f59\">Figure K</a>). Press down on the injection site with the gauze pad for a few seconds or rub gently in a circular motion.<br/>\n<ul class=\"Disc\">\n<li>If you see blood after you press the injection site for a few seconds, wipe it off with the gauze pad and apply an adhesive bandage.\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">\n<br/>\n<a name=\"f59\"></a><img alt=\"Figure K\n\" src=\"/dailymed/image.cfm?name=ple00-0024-59.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n</tbody>\n</table></div>" }

After the Plegridy injection:

{ "type": "p", "children": [], "text": "\nAfter the Plegridy injection:\n" }

{ "type": "ul", "children": [ "\nDo not recap the needle. Recapping the needle can lead to a needle stick injury.\n", "Put your used needles and syringes in a FDA-cleared sharps disposal container right away after use. Do not throw away (dispose of) loose needles and syringes in your household trash.\n", "If you do not have a FDA-cleared sharps disposal container, you may use a household container that is:\nmade of heavy-duty plastic,\n\ncan be closed with a tight-fitting puncture-resistant lid, without sharps being able to come out,\n\nupright and stable during use,\n\nleak-resistant, and\n\nproperly labeled to warn of hazardous waste inside the container.\n\n\n", "When your sharps disposal container is almost full, you will need to follow your community guidelines for the right way to dispose of your sharps disposal container. There may be state or local laws about how you should throw away used needles and syringes. For more information about safe sharps disposal, and for specific information about sharps disposal in the state that you live in, go to the FDA's website at: http://www.fda.gov/safesharpsdisposal\n", "\nDo not dispose of your used sharps disposal container in your household trash unless your community guidelines permit this. Do not recycle your used sharps disposal container.\n" ], "text": "" }

Check your injection site:

{ "type": "p", "children": [], "text": "\nCheck your injection site:\n" }

{ "type": "ul", "children": [ "After 2 hours, check the injection site for redness, pain, itching, swelling, tenderness, a break in your skin that becomes blue and black, or drains fluid. If you have a skin reaction and it does not clear up in a few days, contact your healthcare provider.\n" ], "text": "" }

General information about the safe and effective use of Plegridy

{ "type": "p", "children": [], "text": "\nGeneral information about the safe and effective use of Plegridy\n" }

{ "type": "ul", "children": [ "Always use a new Plegridy prefilled syringe and needle for each injection. Do not re-use your Plegridy prefilled syringe or needles.\n", "\nDo not share your Plegridy prefilled syringe or needles.\n" ], "text": "" }

Manufactured by:

{ "type": "p", "children": [], "text": "Manufactured by:\n" }

Biogen Inc.

{ "type": "p", "children": [], "text": "Biogen Inc.\n" }

Cambridge, MA, 02142, USA

{ "type": "p", "children": [], "text": "Cambridge, MA, 02142, USA\n" }

U.S. License # 1697

{ "type": "p", "children": [], "text": "U.S. License # 1697\n" }

©Biogen Inc. [2021]. All rights reserved.

{ "type": "p", "children": [], "text": "©Biogen Inc. [2021]. All rights reserved.\n" }

1-800-456-2255

{ "type": "p", "children": [], "text": "1-800-456-2255\n" }

This Instructions for Use has been approved by the U.S. Food and Drug Administration.

{ "type": "p", "children": [], "text": "This Instructions for Use has been approved by the U.S. Food and Drug Administration.\n" }

Issued: 1/2021

{ "type": "p", "children": [], "text": "Issued: 1/2021\n" }

54927-01

{ "type": "p", "children": [], "text": "54927-01\n" }

Instructions for Use

{ "type": "p", "children": [], "text": "\nInstructions for Use\n" }

PLEGRIDY® (PLEGG-rih-dee)

{ "type": "p", "children": [], "text": "\nPLEGRIDY®\n(PLEGG-rih-dee)\n" }

(peginterferon beta-1a)

{ "type": "p", "children": [], "text": "\n(peginterferon beta-1a)\n" }

injection for intramuscular use

{ "type": "p", "children": [], "text": "\ninjection for intramuscular use\n" }

Titration Kit for use with the PLEGRIDY intramuscular Single-Dose Prefilled Syringe Only

{ "type": "p", "children": [], "text": "\nTitration Kit for use with the PLEGRIDY intramuscular Single-Dose Prefilled Syringe Only\n" }

Read this Instructions for Use before you start using Plegridy and each time you get a refill. There may be new information. This information does not take the place of talking to your healthcare provider about your medical condition or your treatment.

{ "type": "p", "children": [], "text": "Read this Instructions for Use before you start using Plegridy and each time you get a refill. There may be new information. This information does not take the place of talking to your healthcare provider about your medical condition or your treatment.\n" }

Important information: The tip of the cap of the Plegridy prefilled syringe is made of natural rubber latex. Tell your healthcare provider if you are allergic to rubber or latex.

{ "type": "p", "children": [], "text": "\nImportant information: The tip of the cap of the Plegridy prefilled syringe is made of natural rubber latex. Tell your healthcare provider if you are allergic to rubber or latex.\n" }

Note:

{ "type": "p", "children": [], "text": "\nNote:\n" }

{ "type": "ul", "children": [ "Before you use your Plegridy prefilled syringe for the first time, your healthcare provider should show you or your caregiver how to prepare and inject your Plegridy prefilled syringe the right way.\n", "Each Plegridy prefilled syringe can be used 1 time only. Do not share your Plegridy prefilled syringe with anyone else. By sharing the needle, you may give an infection to them or get an infection from them.\n", "Do not use more than 1 Plegridy prefilled syringe every 14 days.\n" ], "text": "" }

How should I store Plegridy?

{ "type": "p", "children": [], "text": "\nHow should I store Plegridy?\n" }

{ "type": "ul", "children": [ "Store Plegridy in the refrigerator between 36°F to 46°F (2°C to 8°C).\n", "If a refrigerator is not available, Plegridy may be stored at room temperature up to 77°F (25°C) for a total of 30 days.\nYou can store your Plegridy prefilled syringes at room temperature and then put it back in the refrigerator.\n\n\n", "\nDo not freeze Plegridy. Do not use Plegridy that has been frozen.\n", "Store Plegridy in the original carton to protect it from light.\n" ], "text": "" }

Keep the Plegridy Titration Kit, the Plegridy prefilled syringe, and all medicines out of the reach of children.

{ "type": "p", "children": [], "text": "\nKeep the Plegridy Titration Kit, the Plegridy prefilled syringe, and all medicines out of the reach of children.\n" }

Supplies you will need for the Plegridy injection:

{ "type": "p", "children": [], "text": "\nSupplies you will need for the Plegridy injection:\n" }

{ "type": "ul", "children": [ "1 Plegridy Titration Kit that contains:\n1 yellow clip\n\n1 purple clip\n\n\n", "1 Plegridy Administration Dose Pack that contains:\n1 Plegridy prefilled syringe\n\n23 gauge, 1¼ inch long sterile needle\n\n\n" ], "text": "" }

Additional supplies not included in your Plegridy Titration Kit and Plegridy Administration Dose Pack:

{ "type": "p", "children": [], "text": "\nAdditional supplies not included in your Plegridy Titration Kit and Plegridy Administration Dose Pack:\n" }

{ "type": "ul", "children": [ "1 alcohol wipe\n", "1 gauze pad\n", "1 adhesive bandage\n", "a sharps disposal container for throwing away used syringes and needles. See “After the Plegridy injection” at the end of these instructions.\n" ], "text": "" }

Preparing the Plegridy Prefilled Syringe:

{ "type": "p", "children": [], "text": "\nPreparing the Plegridy Prefilled Syringe:\n" }

{ "type": "ul", "children": [ "Find a well-lit, clean, flat work surface like a table and collect all the supplies you will need to give yourself or receive an injection.\n", "Take 1 Plegridy Administration Dose Pack out of the refrigerator and let it come to room temperature for about 30 minutes. Do not use external heat sources such as hot water to warm the Plegridy prefilled syringe.\n", "Check the expiration date printed on the Plegridy prefilled syringe, Plegridy prefilled syringe Administration Dose Package carton, and the outer carton. Do not use the Plegridy prefilled syringe past the expiration date.\n", "Wash your hands with soap and water.\n" ], "text": "" }

Identifying parts of the Plegridy prefilled syringe (See Figure A).

{ "type": "p", "children": [], "text": "\nIdentifying parts of the Plegridy prefilled syringe (See Figure A).\n" }

Preparing the Plegridy injection:

{ "type": "p", "children": [], "text": "\nPreparing the Plegridy injection:\n" }

<div class="scrollingtable"><table width="100%"> <col align="left" width="44.000%"/> <col align="left" width="56.000%"/> <tbody class="Headless"> <tr class="First"> <td align="left" class="Lrule Rrule Toprule" valign="top"><span class="Bold">Step 1:</span> Check the Plegridy prefilled syringe (<a href="#f62">Figure A</a>):<br/> <ul class="Disc"> <li>The syringe should not have any cracks or damage. </li> <li>Check that the cap is intact and has not been removed. </li> <li>Plegridy should look slightly clear, colorless to slightly yellow, and should not have any particles in it. </li> <li> <span class="Bold">Do not</span> use the Plegridy prefilled syringe if:<ul class="Disc"> <li>the syringe is cracked or damaged. </li> <li>the solution is cloudy, colored other than slightly yellow, or has lumps or particles in it. </li> <li>the cap has been removed or is not tightly attached. </li> </ul> </li> </ul> </td><td align="center" class="Rrule Toprule" valign="top"> <br/> <br/> <a name="f62"></a><img alt="Figure A " src="/dailymed/image.cfm?name=ple00-0024-62.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top">If you cannot use that syringe, you will need to get a new<br/>syringe. Contact Biogen at 1-800-456-2255. </td><td align="left" class="Botrule Rrule" valign="top"></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Step 2:</span> With 1 hand, hold the Plegridy prefilled syringe right under the cap and with the cap pointing up (See <a href="#f63">Figure B</a>).<br/> <ul class="Circle"> <li>Make sure you are holding the Plegridy prefilled syringe by the ridged part, directly under the cap. </li> </ul> </td><td align="center" class="Botrule Rrule" valign="top"><a name="f63"></a><img alt="Figure B " src="/dailymed/image.cfm?name=ple00-0024-63.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Step 3:</span> With the other hand, grasp the cap and bend it at a 90º angle until the cap snaps off (See <a href="#f64">Figure C</a> and <a href="#f65">Figure D</a>). </td><td align="center" class="Botrule Rrule" valign="top"> <br/> <a name="f64"></a><img alt="Figure C " src="/dailymed/image.cfm?name=ple00-0024-64.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/><br/> <br/> <a name="f65"></a><img alt="Figure D " src="/dailymed/image.cfm?name=ple00-0024-65.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Step 4:</span> Open the sterile needle package and take out the covered needle. Hold the Plegridy prefilled syringe with the glass syringe tip pointing up. Press the needle on the Plegridy prefilled syringe glass tip (See <a href="#f66">Figure E</a>). </td><td align="center" class="Botrule Rrule" valign="top"><a name="f66"></a><img alt="Figure E " src="/dailymed/image.cfm?name=ple00-0024-66.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr class="Last"> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Step 5:</span> Gently turn the needle to the right (clockwise) until it is tight and firmly attached (See <a href="#f67">Figure F</a>).<br/> <ul class="Disc"> <li>If the needle is not firmly attached, it may leak and you may not get your full dose of Plegridy. </li> <li> <span class="Bold">Do not</span> remove the protective cover from the needle. </li> </ul> </td><td align="center" class="Botrule Rrule" valign="top"><a name="f67"></a><img alt="Figure F " src="/dailymed/image.cfm?name=ple00-0024-67.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table width=\"100%\">\n<col align=\"left\" width=\"44.000%\"/>\n<col align=\"left\" width=\"56.000%\"/>\n<tbody class=\"Headless\">\n<tr class=\"First\">\n<td align=\"left\" class=\"Lrule Rrule Toprule\" valign=\"top\"><span class=\"Bold\">Step 1:</span> Check the Plegridy prefilled syringe (<a href=\"#f62\">Figure A</a>):<br/>\n<ul class=\"Disc\">\n<li>The syringe should not have any cracks or damage.\n</li>\n<li>Check that the cap is intact and has not been removed.\n</li>\n<li>Plegridy should look slightly clear, colorless to slightly yellow, and should not have any particles in it.\n</li>\n<li>\n<span class=\"Bold\">Do not</span> use the Plegridy prefilled syringe if:<ul class=\"Disc\">\n<li>the syringe is cracked or damaged.\n</li>\n<li>the solution is cloudy, colored other than slightly yellow, or has lumps or particles in it.\n</li>\n<li>the cap has been removed or is not tightly attached.\n</li>\n</ul>\n</li>\n</ul>\n</td><td align=\"center\" class=\"Rrule Toprule\" valign=\"top\">\n<br/>\n<br/>\n<a name=\"f62\"></a><img alt=\"Figure A\n\" src=\"/dailymed/image.cfm?name=ple00-0024-62.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\">If you cannot use that syringe, you will need to get a new<br/>syringe. Contact Biogen at 1-800-456-2255.\n</td><td align=\"left\" class=\"Botrule Rrule\" valign=\"top\"></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Step 2:</span> With 1 hand, hold the Plegridy prefilled syringe right under the cap and with the cap pointing up (See <a href=\"#f63\">Figure B</a>).<br/>\n<ul class=\"Circle\">\n<li>Make sure you are holding the Plegridy prefilled syringe by the ridged part, directly under the cap.\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><a name=\"f63\"></a><img alt=\"Figure B\n\" src=\"/dailymed/image.cfm?name=ple00-0024-63.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Step 3:</span> With the other hand, grasp the cap and bend it at a 90º angle until the cap snaps off (See <a href=\"#f64\">Figure C</a> and <a href=\"#f65\">Figure D</a>).\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">\n<br/>\n<a name=\"f64\"></a><img alt=\"Figure C\n\" src=\"/dailymed/image.cfm?name=ple00-0024-64.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/><br/>\n<br/>\n<a name=\"f65\"></a><img alt=\"Figure D\n\" src=\"/dailymed/image.cfm?name=ple00-0024-65.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Step 4:</span> Open the sterile needle package and take out the covered needle. Hold the Plegridy prefilled syringe with the glass syringe tip pointing up. Press the needle on the Plegridy prefilled syringe glass tip (See <a href=\"#f66\">Figure E</a>).\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><a name=\"f66\"></a><img alt=\"Figure E\n\" src=\"/dailymed/image.cfm?name=ple00-0024-66.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr class=\"Last\">\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Step 5:</span> Gently turn the needle to the right (clockwise) until it is tight and firmly attached (See <a href=\"#f67\">Figure F</a>).<br/>\n<ul class=\"Disc\">\n<li>If the needle is not firmly attached, it may leak and you may not get your full dose of Plegridy.\n</li>\n<li>\n<span class=\"Bold\">Do not</span> remove the protective cover from the needle.\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><a name=\"f67\"></a><img alt=\"Figure F\n\" src=\"/dailymed/image.cfm?name=ple00-0024-67.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n</tbody>\n</table></div>" }

Using the Plegridy prefilled syringe with the Plegridy Titration Kit:

{ "type": "p", "children": [], "text": "\nUsing the Plegridy prefilled syringe with the Plegridy Titration Kit:\n" }

{ "type": "ul", "children": [ " You must prepare the Plegridy prefilled syringe and needle before you put it into the Plegridy titration clip. Follow Step 1 to Step 5 above to prepare the Plegridy prefilled syringe.\n", "Your Plegridy dose may be titrated over 2 doses by using the Plegridy prefilled syringe with the Plegridy Titration Kit.\n\nDose 1 (Day 1): ½ dose (yellow clip)\n\n\nDose 2 (Day 15): ¾ dose (purple clip)\n\n\nDose 3 (Day 29): a full dose (no clip needed)\n\n\n", " The 2 Plegridy titration clips are for single-use only with the Plegridy prefilled syringe. Do not re-use the Plegridy prefilled syringe or Plegridy titration clips.\n" ], "text": "" }

Identifying the parts of Plegridy Titration Kit (See Figure G):

{ "type": "p", "children": [], "text": "\nIdentifying the parts of Plegridy Titration Kit (See Figure G):\n" }

{ "type": "ul", "children": [ "The Plegridy titration clip has a “collar” on top that will stop the syringe from injecting a full dose (See Figure H). The “collar” is to make sure that you receive the correct dose.\n" ], "text": "" }

Attaching the Plegridy titration clip:

{ "type": "p", "children": [], "text": "\nAttaching the Plegridy titration clip:\n" }

<div class="scrollingtable"><table width="100%"> <col align="left" width="49.500%"/> <col align="left" width="50.500%"/> <tbody class="Headless"> <tr class="First"> <td align="left" class="Botrule Lrule Rrule Toprule" valign="top"><span class="Bold">Step 6:</span> Choose the right titration clip for your dose.<br/> <br/> <br/> <br/> <br/> <br/> <br/> <br/> <br/> <ul class="Disc"> <li> <span class="Bold">Dose 1 (Day 1):</span> Choose the <span class="Bold">yellow</span> clip to give ½ dose (See <a href="#f70">Figure I</a>).<br/> <br/> </li> <li> <span class="Bold">Dose 2 (Day 15):</span> Choose the <span class="Bold">purple</span> clip to give ¾ dose (See <a href="#f71">Figure J</a>). </li> </ul> </td><td align="left" class="Botrule Rrule Toprule" valign="top"> <br/> <br/> <a name="f70"></a><img alt="Figure I " src="/dailymed/image.cfm?name=ple00-0024-70.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/><br/> <br/> <br/> <a name="f71"></a><img alt="Figure J " src="/dailymed/image.cfm?name=ple00-0024-71.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Step 7:</span> Put the correct titration clip on a flat surface with the door open (See <a href="#f72">Figure K</a>). </td><td align="center" class="Botrule Rrule" valign="top"><a name="f72"></a><img alt="Figure K " src="/dailymed/image.cfm?name=ple00-0024-72.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Step 8:</span> Line up the Plegridy prefilled syringe over the titration clip with the plunger pointing to the left and the needle pointing to the right (See <a href="#f73">Figure L</a>). </td><td align="center" class="Botrule Rrule" valign="top"><a name="f73"></a><img alt="Figure L " src="/dailymed/image.cfm?name=ple00-0024-73.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Step 9:</span> Push the Plegridy prefilled syringe down into the titration clip until both ends “snap” into place (See <a href="#f74">Figure M</a>). </td><td align="center" class="Botrule Rrule" valign="top"><a name="f74"></a><img alt="Figure M " src="/dailymed/image.cfm?name=ple00-0024-74.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Step 10:</span> Using 2 fingers, push the door down until it closes over the Plegridy prefilled syringe (See <a href="#f75">Figure N</a>).<br/> <ul class="Disc"> <li> You will hear a “snap” when the door is closed the right way. <span class="Bold">Do not</span> open door after it is closed. </li> </ul> </td><td align="center" class="Botrule Rrule" valign="top"><a name="f75"></a><img alt="Figure N " src="/dailymed/image.cfm?name=ple00-0024-75.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr class="Last"> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Step 11:</span> Check to make sure that the Plegridy prefilled syringe is in the titration clip the right way and that the door is tightly closed. </td><td align="center" class="Botrule Rrule" valign="top"><a name="f76"></a><img alt="Figure O " src="/dailymed/image.cfm?name=ple00-0024-76.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table width=\"100%\">\n<col align=\"left\" width=\"49.500%\"/>\n<col align=\"left\" width=\"50.500%\"/>\n<tbody class=\"Headless\">\n<tr class=\"First\">\n<td align=\"left\" class=\"Botrule Lrule Rrule Toprule\" valign=\"top\"><span class=\"Bold\">Step 6:</span> Choose the right titration clip for your dose.<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<br/>\n<ul class=\"Disc\">\n<li>\n<span class=\"Bold\">Dose 1 (Day 1):</span>\nChoose the <span class=\"Bold\">yellow</span> clip to give ½ dose (See <a href=\"#f70\">Figure I</a>).<br/>\n<br/>\n</li>\n<li>\n<span class=\"Bold\">Dose 2 (Day 15):</span>\nChoose the <span class=\"Bold\">purple</span> clip to give ¾ dose (See <a href=\"#f71\">Figure J</a>).\n</li>\n</ul>\n</td><td align=\"left\" class=\"Botrule Rrule Toprule\" valign=\"top\">\n<br/>\n<br/>\n<a name=\"f70\"></a><img alt=\"Figure I\n\" src=\"/dailymed/image.cfm?name=ple00-0024-70.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/><br/>\n<br/>\n<br/>\n<a name=\"f71\"></a><img alt=\"Figure J\n\" src=\"/dailymed/image.cfm?name=ple00-0024-71.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Step 7:</span> Put the correct titration clip on a flat surface with the door open (See <a href=\"#f72\">Figure K</a>).\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><a name=\"f72\"></a><img alt=\"Figure K\n\" src=\"/dailymed/image.cfm?name=ple00-0024-72.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Step 8:</span> Line up the Plegridy prefilled syringe over the titration clip with the plunger pointing to the left and the needle pointing to the right (See <a href=\"#f73\">Figure L</a>).\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><a name=\"f73\"></a><img alt=\"Figure L\n\" src=\"/dailymed/image.cfm?name=ple00-0024-73.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Step 9:</span> Push the Plegridy prefilled syringe down into the titration clip until both ends “snap” into place (See <a href=\"#f74\">Figure M</a>).\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><a name=\"f74\"></a><img alt=\"Figure M\n\" src=\"/dailymed/image.cfm?name=ple00-0024-74.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Step 10:</span> Using 2 fingers, push the door down until it closes over the Plegridy prefilled syringe (See <a href=\"#f75\">Figure N</a>).<br/>\n<ul class=\"Disc\">\n<li> You will hear a “snap” when the door is closed the right way. <span class=\"Bold\">Do not</span> open door after it is closed.\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><a name=\"f75\"></a><img alt=\"Figure N\n\" src=\"/dailymed/image.cfm?name=ple00-0024-75.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr class=\"Last\">\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Step 11:</span> Check to make sure that the Plegridy prefilled syringe is in the titration clip the right way and that the door is tightly closed.\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><a name=\"f76\"></a><img alt=\"Figure O\n\" src=\"/dailymed/image.cfm?name=ple00-0024-76.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n</tbody>\n</table></div>" }

Giving the Plegridy injection:

{ "type": "p", "children": [], "text": "\nGiving the Plegridy injection:\n" }

{ "type": "ul", "children": [ "Your healthcare provider should show you or a caregiver how to prepare and inject the dose of Plegridy before the Plegridy prefilled syringe is used for the first time. Your healthcare provider should watch you inject the dose of Plegridy the first time the Plegridy prefilled syringe is used.\n", "Inject your Plegridy exactly as your healthcare provider has shown you.\n", "Plegridy is injected into the muscle (intramuscularly).\n", "Plegridy should be injected into the thigh (See Figure P).\n", "Change (rotate) your injection sites for each dose. Do not use the same injection site for each injection.\n", "\nDo not inject into an area of the body where the skin is irritated, reddened, bruised, infected or scarred in any way.\n" ], "text": "" }

<div class="scrollingtable"><table width="100%"> <col align="left" width="47.200%"/> <col align="left" width="52.800%"/> <tbody class="Headless"> <tr class="First"> <td align="left" class="Botrule Lrule Rrule Toprule" valign="top"><span class="Bold">Step 12:</span> Choose your left or right thigh and wipe the skin with an alcohol wipe (See <a href="#f77">Figure P</a>). Let the injection site dry before injecting the dose.<br/> <ul class="Disc"> <li> <span class="Bold">Do not</span> touch this area again before giving the injection. </li> </ul> </td><td align="center" class="Botrule Rrule Toprule" valign="top"><a name="f77"></a><img alt="Figure P " src="/dailymed/image.cfm?name=ple00-0024-77.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Step 13:</span> Pull the protective cover straight off the needle (See <a href="#f78">Figure Q</a>). <span class="Bold">Do not</span> twist the cover off. </td><td align="center" class="Botrule Rrule" valign="top"><a name="f78"></a><img alt="Figure Q " src="/dailymed/image.cfm?name=ple00-0024-78.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Step 14:</span> With 1 hand, stretch the skin out around the injection site. With the other hand, hold the syringe like a pencil. Use a quick dart-like motion and insert the needle at a 90º angle, through the skin and into the muscle (See <a href="#f79">Figure R</a>). After the needle is in, let go of the skin. </td><td align="center" class="Botrule Rrule" valign="top"><a name="f79"></a><img alt="Figure R " src="/dailymed/image.cfm?name=ple00-0024-79.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Step 15:</span> Slowly push the plunger all the way down until it touches the collar (See <a href="#f80">Figure S</a>). </td><td align="center" class="Botrule Rrule" valign="top"><a name="f80"></a><img alt="Figure S " src="/dailymed/image.cfm?name=ple00-0024-80.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> <tr class="Last"> <td align="left" class="Botrule Lrule Rrule" valign="top"><span class="Bold">Step 16:</span> Pull the needle out of the skin (See <a href="#f81">Figure T</a>). Press down on the injection site with the gauze pad for a few seconds or rub gently in a circular motion.<br/> <ul class="Disc"> <li>If you see blood after you press the injection site for a few seconds, wipe it off with the gauze pad and apply an adhesive bandage. </li> </ul> </td><td align="center" class="Botrule Rrule" valign="top"><a name="f81"></a><img alt="Figure T " src="/dailymed/image.cfm?name=ple00-0024-81.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95"/></td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table width=\"100%\">\n<col align=\"left\" width=\"47.200%\"/>\n<col align=\"left\" width=\"52.800%\"/>\n<tbody class=\"Headless\">\n<tr class=\"First\">\n<td align=\"left\" class=\"Botrule Lrule Rrule Toprule\" valign=\"top\"><span class=\"Bold\">Step 12:</span> Choose your left or right thigh and wipe the skin with an alcohol wipe (See <a href=\"#f77\">Figure P</a>). Let the injection site dry before injecting the dose.<br/>\n<ul class=\"Disc\">\n<li>\n<span class=\"Bold\">Do not</span> touch this area again before giving the injection.\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule Toprule\" valign=\"top\"><a name=\"f77\"></a><img alt=\"Figure P\n\" src=\"/dailymed/image.cfm?name=ple00-0024-77.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Step 13:</span> Pull the protective cover straight off the needle (See <a href=\"#f78\">Figure Q</a>). <span class=\"Bold\">Do not</span> twist the cover off.\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><a name=\"f78\"></a><img alt=\"Figure Q\n\" src=\"/dailymed/image.cfm?name=ple00-0024-78.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Step 14:</span> With 1 hand, stretch the skin out around the injection site. With the other hand, hold the syringe like a pencil. Use a quick dart-like motion and insert the needle at a 90º angle, through the skin and into the muscle (See <a href=\"#f79\">Figure R</a>). After the needle is in, let go of the skin.\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><a name=\"f79\"></a><img alt=\"Figure R\n\" src=\"/dailymed/image.cfm?name=ple00-0024-79.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr>\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Step 15:</span> Slowly push the plunger all the way down until it touches the collar (See <a href=\"#f80\">Figure S</a>).\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><a name=\"f80\"></a><img alt=\"Figure S\n\" src=\"/dailymed/image.cfm?name=ple00-0024-80.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n<tr class=\"Last\">\n<td align=\"left\" class=\"Botrule Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Step 16:</span> Pull the needle out of the skin (See <a href=\"#f81\">Figure T</a>). Press down on the injection site with the gauze pad for a few seconds or rub gently in a circular motion.<br/>\n<ul class=\"Disc\">\n<li>If you see blood after you press the injection site for a few seconds, wipe it off with the gauze pad and apply an adhesive bandage.\n</li>\n</ul>\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"><a name=\"f81\"></a><img alt=\"Figure T\n\" src=\"/dailymed/image.cfm?name=ple00-0024-81.jpg&amp;setid=08f0ea03-4e6d-195d-aef4-886e32befa95\"/></td>\n</tr>\n</tbody>\n</table></div>" }

After the Plegridy injection:

{ "type": "p", "children": [], "text": "\nAfter the Plegridy injection:\n" }

{ "type": "ul", "children": [ "\nDo not recap the needle. Recapping the needle can lead to a needle stick injury.\n", "Put your used needles and syringes in a FDA-cleared sharps disposal container right away after use. Do not throw away (dispose of) loose needles and syringes in your household trash.\n", "If you do not have a FDA-cleared sharps disposal container, you may use a household container that is:\nmade of heavy-duty plastic,\n\ncan be closed with a tight-fitting puncture-resistant lid, without sharps being able to come out,\n\nupright and stable during use,\n\nleak-resistant, and\n\nproperly labeled to warn of hazardous waste inside the container.\n\n\n", "When your sharps disposal container is almost full, you will need to follow your community guidelines for the right way to dispose of your sharps disposal container. There may be state or local laws about how you should throw away used needles and syringes. For more information about safe sharps disposal, and for specific information about sharps disposal in the state that you live in, go to the FDA's website at: http://www.fda.gov/safesharpsdisposal\n", "\nDo not dispose of your used sharps disposal container in your household trash unless your community guidelines permit this. Do not recycle your used sharps disposal container.\n" ], "text": "" }

Check the injection site:

{ "type": "p", "children": [], "text": "\nCheck the injection site:\n" }

{ "type": "ul", "children": [ "After 2 hours, check the injection site for redness, pain, itching, swelling, tenderness, a break in your skin that becomes blue and black, or drains fluid. If you have a skin reaction and it does not clear up in a few days, contact your healthcare provider.\n" ], "text": "" }

General information about the safe and effective use of Plegridy

{ "type": "p", "children": [], "text": "\nGeneral information about the safe and effective use of Plegridy\n" }

{ "type": "ul", "children": [ "Always use a new Plegridy prefilled syringe, titration clip, and needle. Do not re-use your Plegridy prefilled syringe, titration clip, or needle.\n", "\nDo not share your Plegridy prefilled syringe, titration clip, or needle.\n", " You can use the table below to keep track of your injections.\n" ], "text": "" }

<div class="scrollingtable"><table width="100%"> <col align="left" width="23.225%"/> <col align="left" width="23.225%"/> <col align="left" width="23.225%"/> <col align="left" width="30.325%"/> <tbody class="Headless"> <tr class="First"> <td align="center" class="Botrule Lrule Rrule Toprule" valign="middle"><span class="Bold">Day</span></td><td align="center" class="Botrule Rrule Toprule" valign="middle"><span class="Bold">Dose</span></td><td align="center" class="Botrule Rrule Toprule" valign="middle"><span class="Bold">Use Titration Clip</span></td><td align="center" class="Botrule Rrule Toprule" valign="middle"><span class="Bold">Date/Time</span></td> </tr> <tr> <td align="center" class="Botrule Lrule Rrule" valign="top">Day 1 </td><td align="center" class="Botrule Rrule" valign="top">1/2 Dose </td><td align="center" class="Botrule Rrule" valign="top">Yellow </td><td align="center" class="Botrule Rrule" valign="top"></td> </tr> <tr> <td align="center" class="Botrule Lrule Rrule" valign="top">Day 15 </td><td align="center" class="Botrule Rrule" valign="top">3/4 Dose </td><td align="center" class="Botrule Rrule" valign="top">Purple </td><td align="center" class="Botrule Rrule" valign="top"></td> </tr> <tr class="Last"> <td align="center" class="Botrule Lrule Rrule" valign="top">Day 29 </td><td align="center" class="Botrule Rrule" valign="top">Full Dose </td><td align="center" class="Botrule Rrule" valign="top">None </td><td align="center" class="Botrule Rrule" valign="top"></td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table width=\"100%\">\n<col align=\"left\" width=\"23.225%\"/>\n<col align=\"left\" width=\"23.225%\"/>\n<col align=\"left\" width=\"23.225%\"/>\n<col align=\"left\" width=\"30.325%\"/>\n<tbody class=\"Headless\">\n<tr class=\"First\">\n<td align=\"center\" class=\"Botrule Lrule Rrule Toprule\" valign=\"middle\"><span class=\"Bold\">Day</span></td><td align=\"center\" class=\"Botrule Rrule Toprule\" valign=\"middle\"><span class=\"Bold\">Dose</span></td><td align=\"center\" class=\"Botrule Rrule Toprule\" valign=\"middle\"><span class=\"Bold\">Use Titration Clip</span></td><td align=\"center\" class=\"Botrule Rrule Toprule\" valign=\"middle\"><span class=\"Bold\">Date/Time</span></td>\n</tr>\n<tr>\n<td align=\"center\" class=\"Botrule Lrule Rrule\" valign=\"top\">Day 1\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">1/2 Dose\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">Yellow\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"></td>\n</tr>\n<tr>\n<td align=\"center\" class=\"Botrule Lrule Rrule\" valign=\"top\">Day 15\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">3/4 Dose\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">Purple\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"></td>\n</tr>\n<tr class=\"Last\">\n<td align=\"center\" class=\"Botrule Lrule Rrule\" valign=\"top\">Day 29\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">Full Dose\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">None\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\"></td>\n</tr>\n</tbody>\n</table></div>" }

Manufactured for:Biogen Inc.Cambridge, MA 02142 USA©2021 Biogen Inc. All rights reserved. 1-800-456-2255This Instructions for Use has been approved by the U.S. Food and Drug Administration.Revised: 1/2021 54930-01

{ "type": "p", "children": [], "text": "Manufactured for:Biogen Inc.Cambridge, MA 02142 USA©2021 Biogen Inc. All rights reserved. 1-800-456-2255This Instructions for Use has been approved by the U.S. Food and Drug Administration.Revised: 1/2021 54930-01\n" }

Principal Display Panel - Carton Label

{ "type": "p", "children": [], "text": "\nPrincipal Display Panel - Carton Label\n" }

NDC 64406-012-01

{ "type": "p", "children": [], "text": "\nNDC 64406-012-01\n" }

Plegridy-Pen

{ "type": "p", "children": [], "text": "\nPlegridy-Pen\n" }

(peginterferon beta-1a)

{ "type": "p", "children": [], "text": "(peginterferon beta-1a)\n" }

Injection

{ "type": "p", "children": [], "text": "Injection\n" }

63. mcg/0.5 mL

{ "type": "p", "children": [], "text": "\n63. mcg/0.5 mL\n" }

94 mcg/0.5 mL

{ "type": "p", "children": [], "text": "\n94 mcg/0.5 mL\n" }

For subcutaneous use only

{ "type": "p", "children": [], "text": "\nFor subcutaneous use only\n" }

Starter Pack

{ "type": "p", "children": [], "text": "\nStarter Pack\n" }

Contents:

{ "type": "p", "children": [], "text": "Contents:\n" }

Dose 1: 1 Single-Dose 63 mcg/0.5 mLPrefilled Autoinjector

{ "type": "p", "children": [], "text": "Dose 1: 1 Single-Dose 63 mcg/0.5 mLPrefilled Autoinjector\n" }

Dose 2: 1 Single-Dose 94 mcg/0.5 mLPrefilled Autoinjector

{ "type": "p", "children": [], "text": "Dose 2: 1 Single-Dose 94 mcg/0.5 mLPrefilled Autoinjector\n" }

Dispense with enclosed Medicaton Guide

{ "type": "p", "children": [], "text": "Dispense with enclosed Medicaton Guide\n" }

Rx Only

{ "type": "p", "children": [], "text": "\nRx Only\n" }

Biogen®

{ "type": "p", "children": [], "text": "\nBiogen®\n" }

Principal Display Panel - Carton Label

{ "type": "p", "children": [], "text": "\nPrincipal Display Panel - Carton Label\n" }

NDC 64406-011-01

{ "type": "p", "children": [], "text": "\nNDC 64406-011-01\n" }

PlegridyTMPen

{ "type": "p", "children": [], "text": "\nPlegridyTMPen\n" }

(peginterferon beta-1a)Injection

{ "type": "p", "children": [], "text": "(peginterferon beta-1a)Injection\n" }

125 mcg/0.5 mL

{ "type": "p", "children": [], "text": "\n125 mcg/0.5 mL\n" }

For subcutaneous use only

{ "type": "p", "children": [], "text": "\nFor subcutaneous use only\n" }

Every 14 Days

{ "type": "p", "children": [], "text": "\nEvery 14 Days\n" }

Contents: 2 Single-Dose Prefilled Autoinjectors

{ "type": "p", "children": [], "text": "Contents: 2 Single-Dose Prefilled Autoinjectors\n" }

Dispense with enclosed Medication Guide

{ "type": "p", "children": [], "text": "Dispense with enclosed Medication Guide\n" }

Rx only

{ "type": "p", "children": [], "text": "\nRx only\n" }

Biogen®

{ "type": "p", "children": [], "text": "\nBiogen®\n" }

Principal Display Panel - Carton Label

{ "type": "p", "children": [], "text": "\nPrincipal Display Panel - Carton Label\n" }

NDC 64406-016-01

{ "type": "p", "children": [], "text": "\nNDC 64406-016-01\n" }

Plegridy™

{ "type": "p", "children": [], "text": "\nPlegridy™\n" }

(peginterferon beta-1a)Injection

{ "type": "p", "children": [], "text": "(peginterferon beta-1a)Injection\n" }

63 mcg/0.5 mL

{ "type": "p", "children": [], "text": "\n63 mcg/0.5 mL\n" }

94 mcg/0.5 mL

{ "type": "p", "children": [], "text": "\n94 mcg/0.5 mL\n" }

For subcutaneous use only

{ "type": "p", "children": [], "text": "\nFor subcutaneous use only\n" }

Starter Pack

{ "type": "p", "children": [], "text": "\nStarter Pack\n" }

Contents:

{ "type": "p", "children": [], "text": "Contents:\n" }

Dose 1: 1 Single-Dose 63 mcg/0.5 mLPrefilled Syringe

{ "type": "p", "children": [], "text": "Dose 1: 1 Single-Dose 63 mcg/0.5 mLPrefilled Syringe\n" }

Dose 2: 1 Single-Dose 94 mcg/0.5 mLPrefilled Syringe

{ "type": "p", "children": [], "text": "Dose 2: 1 Single-Dose 94 mcg/0.5 mLPrefilled Syringe\n" }

Rx only

{ "type": "p", "children": [], "text": "\nRx only\n" }

Dispense with enclosedMedication Guide

{ "type": "p", "children": [], "text": "Dispense with enclosedMedication Guide\n" }

Biogen®

{ "type": "p", "children": [], "text": "\nBiogen®\n" }

Principal Display Panel - Carton Label

{ "type": "p", "children": [], "text": "\nPrincipal Display Panel - Carton Label\n" }

NDC 64406-015-01

{ "type": "p", "children": [], "text": "\nNDC 64406-015-01\n" }

PlegridyTM

{ "type": "p", "children": [], "text": "\nPlegridyTM\n" }

(peginterferon beta-1a)Injection

{ "type": "p", "children": [], "text": "(peginterferon beta-1a)Injection\n" }

125 mcg/0.5 mL

{ "type": "p", "children": [], "text": "\n125 mcg/0.5 mL\n" }

For subcutaneous use only

{ "type": "p", "children": [], "text": "\nFor subcutaneous use only\n" }

Every 14 Days

{ "type": "p", "children": [], "text": "Every 14 Days\n" }

Contents:

{ "type": "p", "children": [], "text": "Contents:\n" }

2 Single-Dose Prefilled Syringes

{ "type": "p", "children": [], "text": "2 Single-Dose Prefilled Syringes\n" }

Rx only

{ "type": "p", "children": [], "text": "\nRx only\n" }

Dispense with enclosedMedication Guide

{ "type": "p", "children": [], "text": "Dispense with enclosedMedication Guide\n" }

Biogen®

{ "type": "p", "children": [], "text": "\nBiogen®\n" }

Principal Display Panel –Carton Label

{ "type": "p", "children": [], "text": "\nPrincipal Display Panel –Carton Label\n" }

NDC 64406-017-01

{ "type": "p", "children": [], "text": "NDC 64406-017-01\n" }

Plegridy® (peginterferon beta-1a)Injection

{ "type": "p", "children": [], "text": "\nPlegridy®\n\n(peginterferon beta-1a)Injection\n" }

125 mcg/0.5 mL

{ "type": "p", "children": [], "text": "125 mcg/0.5 mL\n" }

For intramuscular use only

{ "type": "p", "children": [], "text": "\nFor intramuscular use only\n" }

Every 14 Days

{ "type": "p", "children": [], "text": "Every 14 Days\n" }

Contents:

{ "type": "p", "children": [], "text": "Contents:\n" }

2 Single-Dose Prefilled Syringes and2 Needles for Injection

{ "type": "p", "children": [], "text": "2 Single-Dose Prefilled Syringes and2 Needles for Injection\n" }

Every 14 Days

{ "type": "p", "children": [], "text": "Every 14 Days\n" }

Dispense with enclosedMedication Guide

{ "type": "p", "children": [], "text": "Dispense with enclosedMedication Guide\n" }

Rx only

{ "type": "p", "children": [], "text": "Rx only\n" }