Preparing for Your Xembify Infusion
Proper preparation is essential for a safe and effective subcutaneous infusion. All steps should be performed using aseptic technique to minimize the risk of infection.
Gather Supplies
Before beginning, ensure you have all the necessary items gathered and laid out on a clean, disinfected surface.
- Xembify vials for the prescribed dose
- An infusion pump
- Sterile syringes and needles, or a transfer device
- Infusion tubing and needle set
- Alcohol wipes
- Adhesive dressings
- A sharps container for disposal
- A treatment diary or logbook
Inspect and Prepare the Medication
- Warm the vials: Allow the Xembify vial(s) to reach room temperature before use. This can take at least 60 minutes. Never warm the medication in a microwave or by placing it in hot water. If the vials have been stored at room temperature (up to 77°F/25°C) for up to 6 months, they must be used immediately and not returned to the refrigerator.
- Visually inspect the solution: Check the vials for clarity, color, and expiration date. Xembify should be a clear to slightly opalescent, colorless or pale yellow solution. Do not use if the solution is cloudy, turbid, discolored, or has particles.
- Clean the vial stopper: After removing the protective cap, wipe the rubber stopper with a new alcohol wipe and let it air-dry completely.
- Withdraw the dose: Using a sterile syringe and needle or a transfer device, withdraw the prescribed amount of Xembify from the vial(s). If using multiple vials, repeat this process until the full dose is withdrawn. Administer the medication within two hours of drawing it into the syringe to avoid particle formation.
Prepare the Infusion Pump and Tubing
- Connect the tubing: Attach the infusion tubing and needle set to the syringe, following the manufacturer's instructions for your specific pump.
- Prime the tubing: Fill the administration tubing with Xembify to ensure all air is removed. Keep the needle dry while priming.
- Load the pump: Load the prepared syringe into the infusion pump according to the pump manufacturer's instructions.
The Xembify Infusion Process
Selecting Infusion Sites
Careful site selection is important to minimize discomfort and ensure proper absorption. Approved sites include:
- Abdomen: Avoid the navel area by at least two inches.
- Thigh: Upper outer area.
- Upper Arm: Upper, outer area.
- Lateral Hip
- Sides and Back
Administering the Infusion
- Prepare the site: Clean the chosen infusion site(s) with a fresh alcohol wipe, using a circular motion and moving outwards. Allow the area to air-dry completely.
- Insert the needle: Pinch at least an inch (2.5 cm) of skin between two fingers and insert the needle into the subcutaneous tissue at a 90-degree angle.
- Check for blood: After inserting each needle, gently pull back on the syringe plunger to check for blood. If blood appears, remove and discard the needle and tubing, then repeat the process at a new site.
- Secure the needle: Once the needle is properly placed, secure it with an adhesive dressing or sterile gauze.
- Start the infusion: Program and start the infusion pump according to your healthcare provider's instructions.
Post-Infusion Care
- Remove needles: After the infusion is complete, turn off the pump and gently remove the needles from the sites.
- Discard materials: Dispose of used needles and tubing in a designated sharps container.
- Clean up: Clean and store your pump and other supplies as instructed by the manufacturer.
- Log the infusion: Record the details of your treatment, including the dose, date, time, and infusion sites, in your treatment log.
Administration Comparison: Adults vs. Children
Infusion parameters for Xembify are tailored by a healthcare provider based on a patient's weight, age, and clinical response. The table below provides a general comparison of typical administration parameters.
| Parameter | Children (2 to <10 years old) | Adults and Adolescents (10+ years old) |
|---|---|---|
| Maximum Volume per Site | 25 mL per site | 25 mL per site |
| Maximum Number of Infusion Sites | ≤ 6 sites | ≤ 6 sites |
| Site Distance | ≥ 2 inches (5 cm) apart | ≥ 2 inches (5 cm) apart |
Important Safety Considerations
While Xembify is generally well-tolerated, be aware of potential side effects and safety concerns:
- Thrombosis (Blood Clots): A Boxed Warning highlights the risk of blood clots, particularly for high-risk patients. Ensure adequate hydration and follow provider guidance.
- Hypersensitivity Reactions: Severe allergic reactions can occur. Stop the infusion immediately and seek medical help if symptoms like shortness of breath or dizziness appear.
- Renal Dysfunction: Patients with pre-existing kidney conditions should be monitored closely. Xembify does not contain sucrose, which can worsen some renal issues, but monitoring is still important.
Conclusion
Understanding how is Xembify administered is key for patients managing primary humoral immunodeficiency at home. The process, which involves careful preparation, selection and rotation of infusion sites, and proper use of an infusion pump, can be safely performed by patients or caregivers after receiving training. Regular monitoring by a healthcare provider is vital to customize parameters and to address any potential side effects. Following these guidelines ensures that patients receive the benefits of therapy effectively and conveniently from home.
For more detailed prescribing information and safety warnings, consult the FDA package insert for Xembify.
