How to take BESREMI®
BESREMI® comes in a single-use, pre-filled syringe containing 500 mcg of ropeginterferon alfa-2b in 1 mL volume. BESREMI® is an injectable at-home treatment that is typically administered once every 2 weeks, though your schedule may be adjusted by your doctor over time.
See the Instructions for Use leaflet that is in your BESREMI® carton for detailed instructions on how to prepare and inject a dose of BESREMI®. You can also access a detailed video here or an Instructions For Use Guide that you can access here.
- Use BESREMI® exactly as your healthcare provider tells you to. Your healthcare provider will tell you how much BESREMI® to inject and when to inject it. Do not inject more than your prescribed dose.
- BESREMI® is given as an injection under your skin (subcutaneous injection). Your healthcare provider should show you how to prepare and measure your dose of BESREMI®, and how to inject yourself before you use BESREMI® for the first time.
- You should not inject BESREMI® until your healthcare provider has shown you how to use BESREMI® the right way. Your healthcare provider will prescribe the amount of BESREMI® that is right for you.
- Always inject BESREMI® exactly as prescribed by your healthcare provider. Do not change your dosing frequency and do not inject more than 1 dose of BESREMI® every 2 weeks without guidance from your healthcare team.
- BESREMI® is for one-time use only. Do not re-use your pre-filled syringe or needle.
- Your healthcare provider should do blood tests before you start BESREMI®, and regularly during treatment to monitor your polycythemia vera, and to check you for side effects.
- Throw away (dispose of) the BESREMI® pre-filled syringe, with needle attached, into a sharps disposal container right away after use.
Storage
Store the BESREMI® carton containing the single-use, prefilled syringe and needle in the refrigerator between 2°C to 8°C (36°F to 46°F). Do not freeze.
Keep out of reach and sight of children.
Take the BESREMI® carton out of the refrigerator and allow it to come to room temperature before use.
Starting dose
The usual starting dose of BESREMI® is 50 mcg or 100 mcg every 2 weeks. This depends on whether or not you were already taking other drugs to treat your disease.
Continuing treatment
Once you start taking BESREMI®, your doctor may gradually increase your prescribed dose and may adjust your dose during treatment until your blood cell counts are stable or until you reach the maximum dose.
Dosing interval
Once you have maintained a stable dose and stable blood counts for at least 1 year, your healthcare provider may choose to expand your dosing interval to once every 4 weeks. It is important to follow the dose and injection schedule recommended by your healthcare provider.
Overdose:
If you have taken more BESREMI® than you should, tell your doctor as soon as possible.
If you think you, or a person you are caring for, have taken too much BESREMI®, contact a healthcare provider, hospital emergency department, regional poison control centre or Health Canada’s toll-free number, 1-844 POISON-X (1-844-764-7669) immediately, even if there are no signs or symptoms.
Missed dose:
You should inject the dose as soon as you remember. However, if more than 2 days have passed since you missed a dose, skip that dose and inject the next dose when it is due. Do not inject a double dose to make up for a forgotten dose. Check with your doctor or pharmacist if you are not sure what to do after missing a dose.
How to inject BESREMI®
We understand that, at first, you could feel a little nervous about injecting BESREMI®. Our goal is to help make you feel as comfortable as possible.
To learn how to give yourself a BESREMI® injection, watch this video, follow step-by-step instructions in the Patient Information leaflet in your BESREMI® package, or speak to a healthcare provider for guidance and assistance.
Read step-by-step instructions.
Speak to a professional:
- A ForYOU™ Nurse Case Manager
- Your pharmacist
- Your doctor’s office
- Your nurse
What to expect
Understanding side effects and what to expect with BESREMI®
Like all medicines, BESREMI® can cause side effects. Not everyone will experience side effects, and they may vary from person to person.
Every person may have a different experience when taking BESREMI®.
Talk to your healthcare provider before taking any medications, including acetaminophen or ibuprofen, to help manage symptoms such as fever, aches, or discomfort.
Individual response to treatment may vary, and your healthcare provider will monitor your response over time.
Possible side effects from using BESREMI®:
- decrease in the number of types of white blood cells (called leukocytes and neutrophils) that may increase your risk of infection, cause fever, chills or unusual fatigue, and in blood clotting cells (called platelets) which can result in bleeding if the number of cells drops too low
- feeling anxious, mood changes
- runny nose, sneezing, coughing, fever
- joint or muscle pain, back pain, bone pain
- increase or decrease in thyroid gland activity, increase of thyroid stimulating hormone leading to fatigue, weight gain or loss, rapid heartbeat, cold intolerance, dry skin
- tiredness, weakness, feeling very sleepy
- dry eyes
- headache
- loss of appetite
- dry mouth, constipation
- diarrhea, abdominal pain
- in blood tests, increases in certain liver enzymes
- itchy skin, hair loss, red skin, increased sweating, dry skin
These are not all the possible side effects you may have when taking BESREMI®. If you experience any side effects not listed here, tell your healthcare provider.
Some side effects can be serious. Your healthcare provider will monitor you during treatment.
Serious side effects
Seek medical attention right away if you experience any of the following:
- Common
- Anxiety: feeling irritable, nervous or panic-stricken
- Atrial fibrillation (when the heart beats very fast and uneven): chest discomfort with unpleasant awareness of your heartbeat, fatigue, weakness, dizziness, shortness of breath, feeling faint
- Cataracts (clouding of the lens of the eye): blurry vision, seeing double, sensitivity to light or glare
- Hypertension (high blood pressure): pounding in the ears, headache, blurred vision
- Pancreatitis (severe and ongoing pain in the stomach area which could be a sign of inflamed pancreas)
- Urinary tract infection (infection in urinary system including kidneys, ureters, bladder and urethra): frequent urination, pain or burning sensation while urinating, blood in the urine, pain in the pelvis, strong smelling urine, cloudy urine
- Influenza like illness (flu like symptoms) only if severe: headache, muscle aches, chills or a fever
- Uncommon
- Liver problems: yellowing of the skin or eyes, dark urine, abdominal pain, nausea, vomiting, loss of appetite, itching
- Unknown
- Endocrine disorders: diabetes, increased thirst, frequent urination, unexplained weight loss, blurred vision, fatigue
- Respiratory problems: shortness of breath, fatigue, dizziness, chest pain, swelling of the ankles or legs
If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, tell your healthcare team.
Travel tips
It’s important to maintain your treatment routine even when you travel.
Be sure to tell the Canadian Air Transport Security Authority (CATSA) officer that you’re carrying a liquid medicine. Ask the Security officer for a visual inspection of your BESREMI® medicine. Do not put BESREMI® through X-ray screening.
You’re allowed to carry BESREMI® in your carry-on bag. It doesn’t need to be placed in a separate clear plastic bag. It’s important to keep BESREMI® cold at all times in a cooler pack until you need it.
After your trip, any syringes that you used must be transported back in an appropriate sharps disposal container. You can put the container in your checked bag or carry-on bag.
Please review the Canadian Federal Government link below for full details on travelling with prescription medications.