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Is Kevzara that has been rerefrigerated still any good?
Is Kevzara (sarilumab) that has been refrigerated still any good or should I dispose of it? It came in a “two-pack.” Two pens, to be taken two weeks, or 14 days, apart.
I am scheduled to take my second dose tomorrow, so I googled Kevzara and started reading and mentally prepping. One site, drugs.com says that Kevzara can reach room temperature in only a few minutes and that it should then be administered within 14 days. It goes on to say DO NOT REFRIGERATE AGAIN. (Other sites seem to copy their statement.) It doesn’t say why or what happens to it if you do though.
The Kevzara website does not say that. It just says to use it within 14 days and it can be kept at room temperature for 14 days. Nothing that I can find about refrigerating after it reaches room temperature.
Does anybody know what happens to Kevzara if it is at room temperature for 1 hour, then put back in a refrigerator?
When I picked it up from the pharmacy, it was NOT cold. I ran a few errands and when I got home I saw (right away) in the paperwork that it should be refrigerated and that it could be administered up to 14 days after reaching room temperature. No where did it say not to refrigerate it. So, I put it in my refrigerator. Three days later I took my first dose (injector pen, preloaded) at my rheumatologist’s office. The next day I was fatigued. A lot!
I’m wondering if refrigerating it made it bad chemically. Poison? Just ineffective? Lost its potency? What?
I’ve messaged my rheumatologist’s office but haven’t heard back.
Why wouldn’t that be in the Kevzara paperwork?
I can’t find any reason why refrigerating causes it to go bad or causes harm to the user.
Does anybody have this answer?
I’ll ask, but I don’t think my pharmacist knows. She had never dispensed it befote me. She had to see if it was something she could get. She gave it to me the day after she received it, and it wasn’t cold, so I’m assuming she didn’t refrigerate it. But between my receiving it from her and arriving home, it certainly reached room temperature.
Has anybody rerefrigerated it after it reached room temperature? Was it safe?
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I'm pretty sure it means after 14 days at room temperature then you shouldn't put Kevzara back into the refrigerator. I have wondered about this too. As long as the liquid is clear and without any particles then I assume it is still good.
@dadcue I thought that thought too. I did message my Rheum., but don’t have an answer yet. Does Actemra have a similar protocol?
@stonewheel
Yes ... everything is the same for Actemra injections. All the precautions and potential side effects are the same too. I used to do Actemra injections until I switched to a monthly IV infusion. The Actemra injections worked but I like doing a monthly infusion better. I don't have to worry about the refrigeration anymore. My injections were by overnight delivery in a styrofoam container with an ice pack or two inside. Those ice packs didn't always stay frozen and so sometimes I wasn't sure how cold the injections stayed inside.
I think fatigue is common especially after the first few injections. When I did my first injections ... I didn't think they did anything at all. I wasn't convinced the injections were working for 3 months until I was able to taper Prednisone by 1 mg per week without having a PMR flare. I had to stay on 3 mg for a long time before tapering completely off because of adrenal insufficiency.
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1 ReactionCall the Kevzara hotline, or the pharmacy that dispensed it to you.
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2 Reactions@stonewheel
I have researched this recently because of the risk of power outages in my area from winter storms. I found this quote about Actemra from an Australian website:
"Once removed from the refrigerator, the pre-filled syringe can be stored up to 2 weeks (14 days) at or below 30°C. The unopened pre-filled syringe may be removed and returned to the refrigerator multiple times as long as the total length of time at or below 30°C is not more than 14 days. The pre-filled syringe must always be kept in the carton to protect from light and keep dry."
I am almost certain I found this same information in an Actemra website, but I haven't been able to find it again today.
When I google "How long can Actemra stay out of the fridge" in AI mode, it gives the same information as above, saying it can be refrigerated multiple times. But if I substitute Kevzara in that search, it says it should not be put back in the refrigerator, and should be used within 14 days.
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1 ReactionFor what it's worth, I felt some extra fatigue after taking the first few Actemra injections. It was always the next day. I don't know if you get a stronger dose since you only take an injection every 2 weeks, and if that would cause more fatigue.
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1 Reaction@tweetypie13 I didn’t know there is a Kevzara hotline. I’ll look for it now. Thanks.
My rheumatologist did message me back this morning and said to use it. I’m still a bit concerned. I’m looking for a Kevzara hotline now.
You should have received some paperwork in the box you received with your Kevzara , the one that has all the fine print. You can also see it on the Kevzara website under “ Prescribing Information” In there it says that Kevzara is to be refrigerated! Never frozen. Mine always came in a styrofoam cooler, wrapped in a bubble wrap and stuffed with frozen reusable ice packs and shipped by FedEx. Overnight. And when I received it I put in immediately in the refrigerator. The night before I would take it out for the next morning. If I would have received it warm from the pharmacy I would not accept it or use it. Mine came from a specialty pharmacy. Call Kevzara 1-844-KEVZARA (538-9272) for your questions.
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2 Reactions@grumpa thanks, that is the information that I have.
My Rheum. said to use it.
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