Questions for people taking Actemra and Kevzara injections

I like your doctor's "DEPRESCRIBE!"
Thx for sharing.
It sounds like all is improving.
Peace for the journey.

On Friday, 8/8 I gave my 8th injection of Kevzara. I'm on 5mg of pred. What is the average # of injections before you see improvement. Does it take a few days after each injection to get the maximum benefit?
Thanks!

More often than not, after I inject Kevzara there is a puddle of medication on my skin when I remove the syringe. I wonder if I'm even getting the full dose. This happens whether the injection site is thigh or abdomen. Does this happen to others? Symptomatically I am doing well and was able to get off the combo of prednisone and methotrexate so I wonder if I should even worry about it.

@margedoc - We merged your post into an existing discussion on the same topic so that you can learn what others have shared. Click the link below to go to the beginning of the discussion.
-- Questions for people taking Actemra and Kevzara injections: https://connect.mayoclinic.org/discussion/questions-for-people-taking-actemra-and-kevzara-injections/

@jeff97, @navymom154, @dadcue, @jam70 and others may have some experience to share with you about puddles around the injection site.

@johnbishop @margedoc I have given myself 90 injections of Actemra in the abdomen. I only had a significant amount of liquid on my skin one time. For some reason that injection was painful, and I released the plunger too early. I always try to wait about 3 seconds after the plunger completes before releasing the plunger. Sometimes it's a little painful to keep holding the plunger down, but I know it's only for a few seconds.

When I give myself an injection I use my left hand to pinch up some skin. I inject into that pinched up area. Because the skin is pinched up, it makes a good seal with the injector pen.

I sometimes have very small drops of liquid or blood after the injection, but it's very minor.

These medications are so expensive I hate to waste any of them!

@margedoc

With any injection of this nature you should leave the needle in for a good 10-15 seconds after the injection. This forms a kind of plug so the medication has time to be absorbed into the tissue before withdrawing the needle. Otherwise, when medications are initially injected, there is some back pressure and some of the medication comes back out. Leaving the needle in before withdrawing it will prevent the back flow so you get the full dose. If there is a small amount of back flow don't worry about it because you still get most of the dose. If some blood comes out just put some finger pressure on it with a sterile gauze or the alcohol wipe.

There are autopen injections but the same principle applies for not withdrawing immediately.

Sometimes people withdraw the needle before all the medication is injected--don't do that!

@dadcue
I also find a puddle with the kevzara injection. The pen automatically pops up and releases so there is no ability to control the pen to remain pressed on the skin.
I assume I am still getting the major portion of the medication to benefit me.

I’ve been on Actemra for about a year. Significant improvement on my PMR and GCA symptoms. I do one injection a week and my specialty pharmacy is about 50 miles away. I’m in Lake Elmo MN.

This only happens to me when I don’t wait for a count of ten after the click. You need to wait a bit longer before you lift the pen from the skin. You’re not getting the complete dose.

Hi @jeff97, I was prescribed Actemra to treat PMR/GCA and I also receive my medication from a specialty pharmacy. I actually had to look up the location of the pharmacy because I had forgotten. I live in Dallas Texas and my pharmacy is in Memphis, Tennessee—several states away. Since I receive my injections by FEDEX, I honestly had not thought about it in a while. I receive 8 well packaged injections at a time. Have to say that I don’t have any concerns about the pharmacy as thankfully each of my orders has arrived well refrigerated with no concerns. Blessings! ❤️