issues pressing release button with Avonex pen

[aspen457]

Hi all,

I'm having issues lately pressing the button with the Avonex pen. Sometimes it seems like it takes forever to set it off. Tonight I had my shot, and when it finally did release I jumped and pulled it right out by accident. I'm so mad at myself! I have no idea how much medication I got in me, probably not much at all. I think I get anxious the longer it takes me to press it.
Anyone have any hints or tips to get it to go off? Sometimes I think I need to start doing thumb exercises.

Thanks for the help!!

[BigA]

It isn't easy. Here are some tips:

Next time, once you have it assembled, without pressing on the button - just touching the top part, press it into your leg and release. Notice how it moves about 1mm and clicks. Press and click. The clicking sound is the release. If you don't have it released, the button wont' press and you'll be frustrated.

So after you practice (but not in the same spot you've been pressing on), place the barrel firmly on your leg, press and listen or the click. Then press the button down.

Extra tip: Save one of the cooling packets from the box when they mail it to you or take some other icepack and wash and dry it. Clean your leg with alcohol and then put the ice on for 5 minutes. It makes it absolutely painless and easy.

Extra tip: If you find it stressful, have your doctor write you a prescription or Xanax or some other tranquilizer. Take it 1/2 hour before your shot.

[lukeduke]

I had the same problem with the Rebif AutoInjector. One night when it went off I jumped and yanked the injector out. I had to start doing the injections manually after that. I don't know the answer to how to get it to release faster. I just always had trouble getting the button pressed to release it.

[thatgirl]

I can relate

I had the exact same thing happen last night. I don't think I got any medicine since I was startled and jerked when the thing finally clicked. Now I'm anxious about trying to inject again.

[Alicious]

The Avonex injector is terrible. I'd be ready for my shot, work myself up to do it (I much prefer manual shots), and then...nothing. Press, press harder, wiggle it a bit, and a few seconds later, BANG!

It's not just you.

[Kenmore]

I agree - I also am not confident that I'm getting all of the medication. At least with the syringe I know the needle is going into my muscle. I had my Dr. change my prescription back to the regular syringe.

Then pen does cause me less anxiety using it, but more anxiety not knowing if the medicine is getting in there.

[BigA]

The Avonex injector is terrible. I'd be ready for my shot, work myself up to do it (I much prefer manual shots), and then...nothing. Press, press harder, wiggle it a bit, and a few seconds later, BANG!

It's not just you.

It's like a gun. You need to remove the safety (by holding onto the top barrel and pressing down. It's designed so that you don't accidently fire it off.

It is NOT like a pen in that you can hold in one had and click down with your thumb. The tube (but not the button) needs to be pressed down until you hear the click. Then the button is ready to press.

Anyone having difficulties can go back to the normal shot like Kenmore, but if you like the pen, you can ask for shot training and they will come back out to your house. Bear in mind that they receive $1000 for each pen, so even if it was gold-plated, there would still be some cash left over. Let them send a nurse out with some practice rounds.

[aspen457]

Thank you all for the feedback! I'm glad that I'm not the only one having some issues with it! I def like taking the pen more than taking the syringe, so I'll keep at it.
BigA, when my nurse came to show me how to use the pen, they showed me how to press down the tube... but they didn't tell me to press till I heard the click, and after that press the button on the top. So maybe that is where I am going wrong.. they showed me how to press on the button and the tube at the same time. I will try your technique next week More to come on how it goes!

[Kenmore]

Aspen - you can call avonex and have them send the nurse out again to show you...they are happy to do it...they can usually be there in a couple of days. There is also an instructional video on youtube...not sure where, but my nurse or the pharmacist told me about it. i think it's better to have the nurse come out though. then you wouldn't have any questions or feel anxious in the future about doing it correctly.

[Alicious]

It's like a gun. You need to remove the safety (by holding onto the top barrel and pressing down. It's designed so that you don't accidently fire it off.

It is NOT like a pen in that you can hold in one had and click down with your thumb. The tube (but not the button) needs to be pressed down until you hear the click. Then the button is ready to press.

I'm well aware of how to use it; I'm saying the design, as compared to other auto-injectors, is terrible. Of course you have to disengage the safety to get it to inject. However, even with the tube pressed down and the injector engaged, whether or not it shoots easily or as expected isn't as predictable as the other injectors. Even the Avonex nurse commented on that when she trained me--that it's actually harder to get it to work than other injectors, even when the safety appears to be off, per her training. Sometimes the button clicks easily, sometimes you have to force it.

It's not user error, it's crappy design.

[Westgrl]

I agree that the button can be hard to push sometimes. If there is a locking mechanism, I don't see the point of making the button so hard to push. You can't accidentally push it if it's locked.

I also notice that the harder it is the push, the more anxious I get, and more likely to flinch. I don't flinch enough to pull it out though. If it goes on the first press then I barely react to it.

[BigA]

It is hard to press. But remember - it's like a car door lock - you can't do both things at the same time. first push the top tube down (but not the button). After the bottom tube goes up into the top a little, there's a tiny click as the safety is released. Only now put your thumb on the button and press.

I you have your thumb on the button before you press down, you'll never do it, or it will be very difficult.

1) press top tube down
2) listen for click
3) Now put your thumb on and press button

[Alicious]

Perhaps your thumbs are just stronger than ours, BigA.

I figure if I injected per the written instructions, the video, the nurse training, and yes, how you describe it, and all four lessons are the exact same, then it's not user error when the button is so hard to depress. YMMV.

[Fed Up]

IDK if this will help; Once you get past the 'trigger' is it fear of pain, that makes you jump? or just the noise?

There is an old nursing trick, lost to attrition; You can pinch the area hard, at the intended site, prior to the injection, then wipe with swap quickly and inject..

or you can 'slap' yourself, where the injection is intended. It makes the area sting and the poke, from the needle, isn't so bad. It works on kids, often.

Ice is a great idea!

And of course, the above suggestions, as well.

Hope this is helpful. Up

[aspen457]

hello all!
thank you for all the feedback!! i had my shot last night and it went well! i pressed down really hard on the tube, i didn't hear the click.. so maybe i still had more to go? and then since i was using my right hand with the shot, i used my left hand to hold on to my forearm (to prevent my arm from jerking out). and then pressed on the button. i didnt hear the click from pressing down on the tube but was trying to listen for it.. and it finally went and i didn't jump! hopefully this will all work ok next week on my left (weaker side).
so since i didn't hear the click releasing the safety.. im assuming i still had farther to press to get it to release? i think it def helped by doing it in this order rather than pressing the tube and button at the same time!