Question about Avonex injections for MS

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Hi there. Do any of you have experience giving Avonex injections to patients with MS? The package insert suggests deltoid and thigh as good sites. I've had one patient who wanted it in her arm, but two that want it in their dorsogluteal muscle. That's where they've always gotten it when not giving it to themselves. I called the company and was told that the arm and thigh were just the sites they did studies on, that people do give it other places, but they can't recommend sites other than those two. I've recently been thinking I should be eliminating the dorsogluteal IM injections in favor of the safer ventrogluteal injections, so am wondering if anyone gives them anywhere other than the "recommended" arm and thigh and, if so, how the patients respond. Thank you!

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Specializes in ICU/CCU; PED'S; SURGERY; MED/SURG; NEURO.

Fo self-injection, I teach the ventrogluteal (although sometimes tough to do on your own) and the vastus lateralis, if someone is going to assist, I teach the previous 2 and add the deltoid and the dorsogluteal.

Biogen can only promote what was studied in the trials, I have worked in MS for 15 years and Avonex came out in 96..some patients have a preferred site but I always encourage them to rotate as much asd possible ex. R thigh - L thigh - R deltoid - L deltoid - R dorsogluteal - L dorsogluteal - etc.

believe it or not the subcutaneous interferons are the most dangerous due to necrosis and higher possiblilty of abscess especially if they do not rotate, some of the MS pts. will pick a site that is numb (doesn't hurt) and then "forget: to rotate and get into trouble.

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Do you have patients who successfully do ventrogluteal self injections? I have one that would really benefit from some site rotation, but doesn't have anyone to help him.

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Specializes in ICU/CCU; PED'S; SURGERY; MED/SURG; NEURO.

I would "map" out a rotation chart for him/her.

The thigh can be divided into at least 6 area on each thing..

Draw him a picture of the thigh and divide it into6 sections.

He/she could cross off or date the spot on their chart. this woukd give him/het 12 areas and would not repeat an area for 12 weeks.

hioe this is helpful

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Good thought! Thanks for your help. :)

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