FIRMAGON is a GnRH receptor antagonist indicated for
treatment of patients with advanced prostate cancer.
DOSAGE AND ADMINISTRATION
FIRMAGON is administered as a subcutaneous injection in
the abdominal region only.
||Maintenance dose - Administration every 28 days
|240 mg given as two subcutaneous injections of 120 mg at a concentration of 40 mg/mL
||80 mg given as one subcutaneous injection at a concentration of 20 mg/mL
The first maintenance dose should be given 28 days after
the starting dose.
Reconstitution And Administration Instructions
FIRMAGON® is to be administered by a healthcare
professional only. Before administering FIRMAGON read the Instructions for
reconstitution and administration carefully.
As with other drugs administered by subcutaneous
injection, the injection site should vary periodically. Injections should be
given in areas of the abdomen that will not be exposed to pressure, e.g., not
close to waistband or belt nor close to the ribs.
FIRMAGON is supplied as a powder to be reconstituted with
Sterile Water for Injection, USP (WFI). The instruction for reconstitution needs
to be carefully followed. Administration of other concentrations is not recommended.
Read the complete instructions before performing the injection.
NOTE: FIRMAGON is for subcutaneous administration
to the abdominal region only.
- Reconstituted drug must be administered within one
hour after addition of Sterile Water for Injection, USP.
- Do not shake the vials.
Follow aseptic technique.
FIRMAGON 240 mg Starting Dose Kit contains:
- 2 vials containing the 120 mg FIRMAGON® powder (a)
- 2 syringes containing Sterile Water for Injection, USP
- 2 vial adapters (c)
- 2 injection needles (d)
- 2 plunger rods (e)
FIRMAGON 80 mg Maintenance Dose Kit contains:
- 1 vial containing the 80 mg FIRMAGON® powder (f)
- 1 syringe containing Sterile Water for Injection, USP (g)
- 1 vial adapter (h)
- 1 injection needle (i)
- 1 plunger rod (j)
In addition the healthcare professional will need:
- gloves (k)
- alcohol pads (l)
- a clean, flat surface (m) to work on, like a table
- a sharps disposal container (n) for throwing away your used
needles and syringes. See “Disposing used needles and syringes” at the end of
The drug product must be prepared using the following
NOTE: The mixing process must be repeated for the
two injections of the Starting Dose prior to injecting the product into the patient's
Step 1: Attaching the vial adaptor to the vial
- Thoroughly wash your hands using soap and water and put
on a pair of clean gloves.
- Place all the supplies required on a clean surface.
- Check that there is powder in the FIRMAGON® vial and that
the Sterile Water, USP is clear and free from particles.
IMPORTANT: DO NOT USE if there is no powder in the
vial or the Sterile Water, USP is discolored.
- Uncap the vial containing the FIRMAGON® powder (o).
- Wipe the vial rubber stopper with an alcohol pad.
IMPORTANT: Do not touch the top of the vial after
- Peel off the seal from the vial adaptor cover.
IMPORTANT: Do not touch the vial adapter.
- Firmly press the vial adaptor (p) onto the vial containing
the FIRMAGON® powder until the adaptor snaps into place.
- Pull the vial adaptor cover off the vial.
Step 2: Assembling the syringe
- Insert the plunger rod (q) into the prefilled syringe containing
Sterile Water, USP (r) and screw the plunger rod clockwise to tighten.
IMPORTANT: Do not pull the back stopper (flange)
(s) off the syringe.
NOTE: You will only feel light resistance screwing
the plunger rod in position.
Step 3: Transferring sterile water, USP from the
syringe to the vial
- Unscrew the gray syringe plug (t) attached to the Luer
lock adaptor on the syringe.
IMPORTANT: Do not pull off the Luer lock adaptor
- Carefully twist the prefilled syringe containing sterile
water, USP onto the vial adapter on the FIRMAGON® powder vial, until it is
IMPORTANT: Be careful not to over twist the
- Press the plunger slowly to transfer all the sterile water,
USP from the syringe to the FIRMAGON® powder vial.
Step 4: Preparing the reconstituted injection
- With the syringe still attached to the vial adaptor, swirl
gently until the liquid is clear with no powder or visible particles.
- Do not shake the vial as this will cause bubbles.
- Reconstitute just prior to administration.
NOTE: If the powder adheres to the side of the
vial, tilt the vial slightly. A ring of small air bubbles on the surface of the
liquid is acceptable.
Reconstitution time can take up to 15 min but usually
takes a few minutes.
Step 5: Transferring the liquid to the syringe
- Turn the vial completely upside down and pull down the
plunger to withdraw all of the reconstituted liquid from the vial to the
- Tap the syringe gently with your fingers to raise air bubbles
in the syringe tip.
- Press the plunger to the line marked on the syringeto
expel all air bubbles.
Step 6: Preparing the syringe for injection
- Holding the vial adaptor detach the syringe from the vial
by unscrewing the syringe from the vial adaptor.
NOTE: Reconstitute just prior to administration.
- While holding the syringe with the tip pointing up, screw
the injection needle (v) clockwise (right) onto the syringe.
Step 7: Preparing the patient
- Select one of the four available injection sites on the abdomen.
- Do not inject in areas where the patient will be exposed
to pressure, such as area around the belt of the waistband or close to the
- Vary the injection site periodically during treatment to
minimize discomfort to the patient.
- Clean the injection site with an alcohol pad.
Step 8: Performing the injection
- Move the needle shield (w) away from the needle and
carefully remove the needle cover (x).
- Pinch and elevate the skin of the abdomen.
- Insert the needle into the skin at a 45 degree angle all
the way to the hub.
- Do not inject into a vein or muscle. Gently pull back the
plunger to check if blood is aspirated.
IMPORTANT: If blood appears in the syringe, the
product should not be injected. Discontinue the injection and discard the
syringe and the needle (reconstitute a new dose for the patient).
- Perform a slow, deep subcutaneous injection
over 30 seconds.
- Remove the needle and then release the skin.
IMPORTANT: Do not rub the injection site after
retracting the needle.
Step 9: Locking the needle into the shield
- Position the needle shield approximately 45 degrees to a
- Press down with a firm, quick motion until a distinct,
audible “click” is heard.
- Visually confirm that the needle is fully engaged under
the lock (y).
IMPORTANT: Syringe is for single use only. Do not
reuse the syringe and needle.
Step 10: Advising the patient
- Instruct the patient not to rub or scratch the injection site.
- Inform that some patients may feel a lump at the injection
site and experience redness, soreness and discomfort for a few days after the
Disposing used needles and syringes
- Put used alcohol swabs, needles and syringes in an
FDA-cleared sharps disposal container right away after use. Do not throw
away loose needles and syringes in the trash.
- For more information about safe sharps disposal, go to
the FDA's website at: http://www.fda.gov/safesharpsdisposal.
Dosage Forms And Strengths
One starting dose comprises 240 mg given as two 3 mL
injections of 120 mg each.
Powder for injection 120 mg:
One vial of FIRMAGON 120 mg contains 120 mg degarelix.
Each vial is to be reconstituted with a prefilled syringe containing 3 mL of Sterile
Water for Injection. 3 mL is withdrawn to deliver 120 mg degarelix at a concentration
of 40 mg/mL.
One maintenance dose comprises 80 mg given as one 4 mL
Powder for injection 80 mg:
One vial of FIRMAGON 80 mg contains 80 mg degarelix. Each
vial is to be reconstituted with a prefilled syringe containing 4.2 mL of
Sterile Water for Injection. 4 mL is withdrawn to deliver 80 mg degarelix at a concentration
of 20 mg/mL.
Storage And Handling
FIRMAGON is available as:
NDC 55566-8403-1, Starting dose – One carton contains:
Two vials each with 120 mg powder for injection
Two prefilled syringes containing 3 mL of sterile water
for injection, USP
Two vial adapters
Two administration needles
NDC 55566-8303-1, Maintenance dose – One carton contains:
One vial with 80 mg powder for injection
One prefilled syringe containing 4.2 mL of sterile water
for injection, USP
One vial adapter
One administration needle
Store at 25°C (77°F); excursions permitted to 15-30°C
Discard all components safely in an appropriate biohazard
Manufactured for: Ferring Pharmaceuticals Inc.,
Parsippany, NJ 07054. By: Rentschler Biotechnologie GmbH, Germany. Revised: Oct 2015