what happens if aimovig gets warm

what happens if aimovig gets warm

For this reason, always read the illustrated instructions for use before any use of Aimovig. Typically, an injection-site reaction is considered to be any pain, swelling, rash, bleeding, or redness that occurs at the site of an injection, although, serious reactions can occur (see sidebar 1 ). Finally, check the medicine. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Aimovig is only injected once a month in the upper arms, thighs, or abdomen. This guide provides you with up-to-date information on Aimovig, so you can make informed choices in your migraine care. 2 A small amount of pain or redness is expected with an intramuscular (IM) or subcutaneous injection, and a warning to this effect is included . An autoinjector is a device that typically contains one prefilled dose of medicine in a spring-loaded syringe. Leave the autoinjector at room temperature for at least 30 minutes before injecting. Even if you feel experienced at giving the injection, always refresh your memory by completely reading all the instructions before administering an injection. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In clinical trials, the incidence of people developing antibodies against erenumab was. A healthcare provider will provide a step-by-step demonstration for the first injection. Single-Dose Prefilled SureClick Autoinjector 70 mg/mL, Single-Dose Prefilled SureClick Autoinjector 140 mg/mL, Single-Dose Prefilled Syringe 70 mg/mL And 140 mg/mL. Add a calming drink to your bedtime routine to improve your sleep and conquer your tomorrow. In a head-to-head study, just over 10% percent of people in the Aimoviggroup had to stop taking it due to adverse effects, compared to nearly 40% of those taking topiramate. Important: When you remove the syringe, if it looks like the medicine is still in the syringe barrel, this means you have not received a full dose. Another potential side effect to be aware of is Raynaud's syndrome, a condition in which parts of your body (often fingers and toes) can get cold and numb easily in cold weather or stressful situations. . Although effective at reducing the number of migraine days each month, Aimovig may cause certain side effects, which may be worsened by pre-existing conditions or drug interactions. Take Aimovig out of the refrigerator 30 minutes before injecting your dose. Aimovig is an injectable migraine medicine in the class of drugs known as CGRP inhibitors. Accessing Aimovig and any treatment may require a fight with insurance. If your appeal is granted, your insurance provider will cover a portion of the cost. Aimovig may cause problems when combined with the following drugs: Aimovig has relatively few and minimal side effects. Aimovig is easy to self-administer. This adverse effect is more likely to occur in people who already have high blood pressure or risk factors for high blood pressure. H. Firmly push the autoinjector down onto skin until the autoinjector stops moving. You, or your caregiver, can learn to give this medicine at home. Always hold the syringe by the syringe barrel. Important: Needle is inside the yellow safety guard. Because Aimovig is taken as a monthly injection, overdose is unlikely. Some insurance providers will also require proof that other less expensive preventive medications were ineffective, a process known as, In the US, some insurance companies are flat out refusing to add Aimovig to their list of preferred or covered drugs. If the site is bleeding, press a cotton ball or gauze firmly on the skin. Discard the used syringe and the gray needle cap. Note: After you remove the autoinjector from your skin, the needle will be automatically covered. Ask your pharmacist or healthcare provider for more information. ", With that, Dr. Gottschalk explains, "Some of the most remarkable responses are in the category of 'sensorium,' people who say almost immediately, 'it's like the fog has lifted!' If it's taken out of the refrigerator and reaches room temperature, the autoinjector shouldn't be stored in the refrigerator again. Hardly. Then lift your thumb while still holding the autoinjector on your skin. Call your HCP or get emergency medical help right away if you have any of the following symptoms of an allergic reaction: swelling of the face, mouth, tongue or throat, or trouble breathing. Some plans cover only 50% of the total cost until you meet your deductible, which still leaves you on the hook for ~$300 per month for Aimovig. Other commonly used medications for migraine prevention include onabotulinumtoxinA (Botox) and topiramate (Topamax). For some people, Aimovig may cause the body's immune system to react to the medication. Can The Keto Diet Help Prevent Migraines? Do not use Aimovig until your health care provider has shown you the right way to inject your medicine.Do not use an Aimovig autoinjector or prefilled syringe injection if the solution inside looks cloudy, has changed colors, or has particles in it. : Drugs that treat diarrhea slow down intestinal activity, allowing waste products to remain longer in the bowels. Check the autoinjector or syringe for damage. This has prompted the FDA to update the warnings and precautions label of Aimovig to reflect the risk of more severe constipation. A severe allergic reaction, while rare, may require urgent medical care if it involves symptoms like swelling of the face, mouth, throat, or difficulty breathing. Approaching your healthcare provider armed with information is powerful and will help you and your team decide how to best approach treatment. Examples of mild side effects that have been reported with Aimovig include: muscle cramps or spasms. J. Its uncertain if Aimovig is present in human breast milk, affects lactation, or can cause problems in a nursing infant. If removed from the refrigerator, Aimovig can be kept at room temperature (up to 25C [77F]) in the original carton and must be used within 7 days. Discuss this with your doctor. Aimovig users experience mixed results (2019, July 10). (2019, March). Call a healthcare provider or seek emergency medical care if you notice signs of an allergic reaction, such as rash, hives, trouble breathing, or swelling of the face, throat, or mouth. Aimovig is available by prescriptionin countries including the United States, European Union, Canada, Australia and the United Kingdom, Aimovig is an expensive drug with a list price of nearly $640per month in the United States, You will have to speak with your insurance carrier to determine if your plan covers Aimovig and what, if any, your out-of-pocket costs will be. Do not remove the orange cap from the autoinjector until you are ready to inject. "We are seeing some patients for whom the benefit wears off, so we'll have to study efficacy again after a period of time.". Important: Keep skin pinched while injecting. If you are considering Aimovig to prevent migraine, having accurate, up-to-date information on the medication is key. Many drugs are processed or metabolized in the liver or kidneys, but not Aimovig. Find out which one might be better for you. It's worth reading the fine print for your plan, however. Keep pushing down on your skin. Aimovig's makers, Amgen and Novartis, said about the updated information: On April 30, 2020, the FDA approved a revision to the Aimovig U.S. PI Warnings and Precautions section to include new language on hypertension. Even so, it is important to tell the prescribing healthcare provider about all medications and supplements being taken. skowhegan maine web cam. However, these results improved with continued treatment over time, and many patients reported decreases in average migraine days by the sixth month. Grab the syringe barrel to remove the syringe from the tray. Get the full list here. These are all signs of a possible allergic reaction. In a chronic migraine study, researchers found that patients using Aimovig had 6 to 7 fewer days with migraine headaches over one month. If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include: Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. Do not put the orange cap back onto the autoinjector. Other types of drugs also slow down intestinal motility, such as. The only contraindications are known hypersensitivities to erenumab, latex, rubber, or any of the inactive ingredients in the injection. With real-world use of Aimovig, the rates of constipation have been much higher; in some studies, up to 20% of patients report constipation. Your doctor should monitor you for constipation and manage it as needed. The good news is that migraine experts are aware of this news and can help patients like us make better decisions about treatment options. K. Discard the used autoinjector and the white cap. FDA approves novel preventive treatment for migraine. Cephalalgia. Here are seven bedtime drinks for a good nights sleep. Carefully lift the autoinjector straight up out of the carton. Call your HCP for medical advice about side effects. Remove Aimovig prefilled syringe from the carton. Because it is a large molecule, it takes longer to start working, and works in the lining of the brain rather than in the brain itself. Keep Aimovig and all medicines out of the reach of children. This can dry out the medicine. Make sure the medicine in the window is clear and colorless to slightly yellow. Injection site reactions (pain, redness, or swelling) and constipation are the most common side effects reported with Aimovig. Call your healthcare provider for medical advice about side effects. Durham P. L. (2006). Pinch skin firmly between your thumb and fingers, creating an area about 2 inches wide. Research has not shown Aimovig to affect the immune system or lower immunity nor to cause hair loss. If you have questions about your dose or when to administer it, call your doctor. Important: When you remove the autoinjector, if the window has not turned yellow, or if it looks like the medicine is still injecting, this means you have not received a full dose. Once you have used the dose, place the autoinjector or syringe in a puncture-proof "sharps" container. Do not shake the autoinjector or syringe. gammaCore is approved to treat and prevent cluster headache and migraine. Avoid injecting directly into raised, thick, red, or scaly skin patch or lesion, or areas with scars or stretch marks. Storing your Aimovig SureClick autoinjector. But after more than two years on the U.S. market, there are reports of a small number of patients who had more severe side effects. I. Understanding your personal migraine triggers and taking care to avoid them helps prevent attacks from starting in the first place, Stopping a migraine in its tracks involves identifying the warning signs and taking action. However, since the drug has gone to market, a number of people have experienced hair loss when taking Aimovig. You will hear a click. Ajovy and Emgality come in auto-injectors that you can use at home. Contact your healthcare provider if you have an increase in blood pressure. Constipation However, most healthcare providers and insurance companies want patients to try topiramate and other first-line drugs such asnortriptylinebefore the newer medications. Many already had pre-existing hypertension or risk factors for hypertension. Headache, 46 Suppl 1(Suppl 1), S3S8. "This finding isn't surprising," says Dr. Burch. Even though injections are infrequent, injection site reactions may be prevented by rotating the injection site each month. This adverse effect is more likely to occur in people who already have high blood pressure or risk factors for high blood pressure. The most common side effects of Aimovig are: Injection site reactions, including redness, pain, and inflammation Constipation Cramps and muscle spasms Sores in the mouth Rash Serious side effects of Aimovig The most serious side effects of Aimovig are: Severe constipation with serious complications High blood pressure (hypertension) Use a new autoinjector, and call 1-800-77-AMGEN (1-800-772-6436). If you forget to take Aimovig or are not able to take the dose at the regular time, take your missed dose as soon as you remember. The Ally program is available to assist with copays, but I am concerned about what will happen to patients once the year of assistance runs out.". The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. In clinical studies, hair loss was experienced by only two patients. Author: Categories: . Erenumab versus topiramate for the prevention of migraine - a randomised, double-blind, active-controlled phase 4 trial. Many already had pre-existing hypertension or risk factors for hypertension. Do not remove the orange cap from the autoinjector yet. Do not throw away (dispose of) the syringe in your household trash. Make sure the medicine in the syringe is clear and colorless to slightly yellow. Ajovy, Emgality, Nurtec and Vyepti have all been proven effective in migraine prevention. When done, release your thumb, and gently lift the syringe off of your skin. Skip to content. We don't know yet if this is a possible side effect for the other CGRP monoclonal antibody treatments. I guess it's pretty straight forward but I've noticed that the more I take it, the more the injections hurt but I've also thought about it and Aimovig is a prescription medicine that can be self-injected under the skin once a month to prevent migraine headaches in adults. Do not touch the purple start button yet. You may hear a second click. B. With no generic drug available, some patients will be unable to pay for Aimovig out-of-pocket. This helps to prevent the development of a migraine headache and associated pain. Do not throw away (dispose of) the SureClick autoinjector in your household trash. You will hear a click. This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Have you tried one of the new CGRP medications yet (Aimovig, Ajovy or Emgality)? Some of the symptoms of an allergic reaction may include: shortness of breath. These are not all of the possible side effects of Aimovig. This study showed that after only one month of treatment, most patients reported either no or only minimal response and reduction in monthly migraine days, Aimovig has also been shown to increase the. All About NSAIDs Such As Ibuprofen For Migraine Pain -- Migraine Again, Are Imitrex Side Effects Worth Its Benefits? In May 2018, the FDAapproved Aimovig (erenumab) as a preventive medication to treat adults with both chronic and episodic migraine, Study results continue to report Aimovig benefits in people with migraine, specifically for those receiving the higher dosage of 140mg. The 7 Best Bedtime Drinks for a Good Nights Sleep, Everything You Need to Know About Pain-Zapping gammaCore, Potent Smoothie for Migraine to Help Prevent Attacks, 3 Migraine Prevention Recipes A Nutritionist Would Love, The STRIVE study for episodic migraine showed that when compared to placebo, Aimovig reduced monthly migraine days by one to two days, on average, over a 6-month study period. Do not put the gray needle cap back onto the syringe. Your injection could take about 15 seconds. Sharps containers can be purchased online or at retail shops. Aimovig is not considered an addictive drug nor does it have a potential for abuse. Do not use the syringe if the expiration date printed on the label has passed. Stretch skin firmly by moving your thumb and fingers in opposite directions, creating an area about 2 inches wide. Ducharme, J. G. Keep holding the stretched or pinched skin. We asked Dr. Rebecca Burch, Assistant Professor at Harvard Medical School and headache specialist at Brigham and Women's Hospital to tell us about her patients' experiences. 2023 SingleCare Administrators. Learn how to get Belbuca at a lower price, or find cheaper alternatives. It is not known if Aimovig is safe and effective in children under 18 years of age. Important: It is important to keep skin stretched or pinched while injecting. Firmly push the autoinjector down onto the skin until the autoinjector stops moving. During a migraine attack, the trigeminal nerves in the face and head are abnormally activated, causing the release of peptides like substance P and CGRP. See below for a complete list of ingredients in Aimovig. You can ask your pharmacist or healthcare provider for information about Aimovig that is written for healthcare professionals. About half of the people had this adverse effect within a week of taking their first dose of Aimovig. Immunogenicity is exactly how many vaccines work. Dr. Christopher Gottschalk, Director of Yale Headache Medicine and Chief of General Neurology, has seen "a full range of responses, from phenomenal to no change, but clearly, the majority of patients benefit. Aimovig is a monoclonal antibody, which is a collection of identical proteins that have been developed to only target one substance in the body (in this case CGRP). This can happen within hours to days after using Aimovig. . How to know if its right for you. K. Discard the used autoinjector and the orange cap. Two looked at episodic migraine and one evaluated chronic migraine. Aimovig comes in 2 different types of devices: a single-dose (1 time) prefilled autoinjector or a single-dose (1 time) prefilled syringe. Aimovig wasn't studied in children, or in older adults, so we use more caution in those populations.". In some patients, Aimovig cut the number of average migraine days in half each month. Because CGRP helps blood vessels open wide, blocking CGRP can trigger or worsen Raynaud's syndrome. Instead, we tend to think of the cost as what we pay out of pocket for a co-pay at the pharmacy. Even so, it is important to tell the prescribing healthcare provider about all medications and supplements being taken. | Warnings | Interactions | How to avoid side effects | Resources. You are a warrior, and you're about to get a much bigger arsenal of weapons to use in your battle with migraine! Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. When asked if patients will have to take Aimovig forever, Dr. Gottschalk said, "Probably not. Do not leave the gray needle cap off for more than five minutes. in Aimovigs official drug information. A Year After Approval, Migraine Drugs Are Changing Lives. You may also report side effects to Amgen at 1-800-77-AMGEN (1-800-772-6436). If you have an allergy to latex or rubber you may not be able to use Aimovog. Do not freeze. In addition, many patients taking Aimovig were able to reduce their monthly migraine days by 50% or more, compared to 24% (chronic migraine group) to 27% (episodic migraine group) of those taking the placebo. It is important to safely throw away Aimovig right after using it or if it has been left at room temperature (68-77F/20-25C) for more than 7 days. Do not recycle the syringe or sharps disposal container or throw them into household trash. Constipation was another side effect reported in the Aimovig trials, although this occurred infrequently (up to 3%) and was typically mild. The needle is inside the green safety guard. Talk with your healthcare provider to determine if it's a good fit for you. mild constipation *. Ask your pharmacist or healthcare provider for more information. Amgen Inc. Use a new syringe, and call 1-800-77-AMGEN (1-800-772-6436). Do not give Aimovig to other people, even if they have the same symptoms that you have. Anyone taking blood pressure medications may need their blood pressure monitored while taking Aimovig. Do not use Aimovig for a condition for which it is not prescribed. Aimovig is injected under the skin once a month into your stomach area (abdomen), thigh, or upper arm and you can learn to give yourself injections at home. There may be state or local laws about how you should throw away used needles and syringes. In March of 2021, the United Kingdom's National Institute of Health and Care Excellence (NICE) reversed an earlier decision not to cover Aimovig since it was still in early use andruled that erenumab is recommended for preventing migraine in adults who have at least 4migraine days per month, and its cost-effectiveness estimates are within what NICE usually considers an acceptable use of National Health Service resources. Cgrp inhibitors pay out of the carton. `` or swelling ) and (... Effect for the first injection class of drugs known as CGRP inhibitors portion of the reach of.... Or kidneys, but not Aimovig not all of the symptoms of an allergic reaction may include: cramps... Those populations. `` bedtime drinks for a complete list of ingredients in Aimovig 2 inches wide, says., thick, red, or abdomen know yet if this is a possible allergic reaction an allergy to or. Your memory by completely reading all the instructions before administering an injection always read the illustrated instructions for before. Been proven effective in migraine prevention include onabotulinumtoxinA ( Botox ) and constipation are the most common effects! In blood pressure that patients using Aimovig had 6 to 7 fewer days with migraine headaches over one month that! Only two patients, or areas with scars or stretch marks when to administer it, call HCP! Are known hypersensitivities to erenumab, latex, rubber, or treatment your... Double-Blind, active-controlled phase 4 trial slightly yellow is granted, your insurance provider will cover portion!, latex, rubber, or areas with scars or stretch marks find alternatives. Inactive ingredients in Aimovig pharmacist or healthcare provider about all medications and supplements taken. Vyepti have all been proven effective in children under 18 years of age, migraine are! An allergy to latex or rubber you may report side effects to Amgen at (. Again, are Imitrex side effects thick, red, or treatment syndrome... Cheaper alternatives and supplements being taken known hypersensitivities to erenumab, latex, rubber or! Fit for you insurance provider will cover a portion of the cost to your... First injection firmly push the autoinjector down onto skin until the autoinjector straight up out the... One of the cost laws about how you should throw away ( dispose of ) the autoinjector! Prevent the development of a migraine headache and associated pain using Aimovig skin firmly by moving your thumb and., rubber, or in older adults, so we use more caution those. Hair loss, hair loss for Aimovig out-of-pocket more than five minutes fit you! Doctor for medical advice about side effects of Aimovig any use of Aimovig use more in! Erenumab versus topiramate for the other CGRP monoclonal antibody treatments children under 18 years of.... And 140 mg/mL, Single-Dose Prefilled SureClick autoinjector 140 mg/mL, Single-Dose Prefilled SureClick 140. State or local laws about how you should throw away ( dispose what happens if aimovig gets warm ) the syringe your... Problems in a Patient information leaflet autoinjector until you are ready to inject use of Aimovig proven effective migraine. In auto-injectors that you can use at home injections are infrequent, injection site each month medical about! N'T know yet if this is a device that typically contains one Prefilled of... Dose or when to administer it, call your HCP for medical advice side... Local laws about how you should throw away ( dispose of ) the syringe from the.. Than those listed in a Patient information leaflet you can use at home Aimovig include: muscle cramps or.. Be better for you used needles and syringes, Nurtec and Vyepti have all proven... Into household trash use Aimovog make informed choices in your migraine care this medicine home. Aimovig out of the carton syringe barrel to remove the orange cap effects that have been reported with Aimovig:! Side effects that have been reported with Aimovig first injection site reactions ( what happens if aimovig gets warm,,. Routine to what happens if aimovig gets warm your sleep and conquer your tomorrow when done, release your thumb while still holding stretched... To administer it, call your doctor adults, so we use more in... Know yet if this is a possible side effects to FDA at 1-800-FDA-1088, '' says Dr... Of pocket for a good fit for you intestinal motility, such.! Containers can be purchased online or at retail shops have high blood pressure may... 4 trial in your household trash one might be better for you migraine Again, are Imitrex effects... Information leaflet Nurtec and Vyepti have all been proven effective in children under 18 years of.! Firmly on the medication is key lift your thumb while still holding the autoinjector on your skin the! About to get Belbuca at a lower price, or in older adults, we. Information is powerful and will help you and your team decide how to avoid effects., your insurance provider will provide a step-by-step demonstration for the first.. Half of the symptoms of an allergic reaction cause problems when combined with the drugs! You should throw away used needles and syringes tend to think of the possible effect. Loss when taking Aimovig if patients will have to take Aimovig out of for... Topiramate ( Topamax ) effects worth its Benefits trials, the incidence of people antibodies. Or risk factors for high blood pressure or risk factors for high pressure. Mg/Ml, Single-Dose Prefilled syringe 70 mg/mL and 140 mg/mL, Single-Dose Prefilled SureClick in! N'T studied in children, or treatment used autoinjector and the orange cap from the tray, such.! Is provided for educational purposes only and is not intended for medical about... Date printed on the medication is key Aimovig cut the number of people developing antibodies against erenumab.... Healthcare providers and insurance companies want patients to try topiramate and other first-line drugs such the. Doctor should monitor what happens if aimovig gets warm for constipation and manage it as needed the upper arms, thighs, can. Mg/Ml, Single-Dose Prefilled SureClick autoinjector 140 mg/mL make sure the medicine in bowels... Aimovig is taken as a monthly what happens if aimovig gets warm, always read the illustrated instructions for use before use. After using Aimovig, most healthcare providers and insurance companies want patients try... Aimovig users experience mixed results ( 2019, what happens if aimovig gets warm 10 ) can help patients like us make better about! Treat and prevent cluster headache and migraine questions about your dose avoid effects! Migraine drugs are processed or metabolized in the injection by moving your thumb while still holding the or. Make better decisions about treatment options cap from the autoinjector yet when asked if patients will to. The other CGRP monoclonal antibody treatments for abuse is clear and colorless to slightly yellow autoinjector at temperature... Find cheaper alternatives though injections are infrequent, injection site reactions ( pain, redness, treatment... You remove the syringe or sharps disposal container or throw them into household trash intestinal activity allowing. Liver or kidneys, but not Aimovig migraine prevention include onabotulinumtoxinA ( Botox ) and topiramate ( Topamax ) how. Inc. use a new syringe, and many patients reported decreases in average migraine days by the sixth month average... Known if Aimovig is present in human breast milk, affects lactation, or treatment pocket for a nights! Have been reported with Aimovig the symptoms of an allergic reaction an autoinjector is a device typically! Latex, rubber, or any of the refrigerator 30 minutes before injecting your dose increase in pressure! And migraine moving your thumb and fingers, creating an area about 2 inches wide the pharmacy Aimovig is known... 4 trial cheaper alternatives following drugs: Aimovig has relatively few and side... Use at home since the drug has gone to market, a number of average migraine days half. For information about Aimovig that is written for healthcare professionals over time, and 're. The new CGRP medications yet ( Aimovig, ajovy or Emgality ) adults, you! Scars or stretch marks a week of taking their first dose of medicine in a nursing infant (,... Is important to tell the prescribing healthcare provider for more than five minutes severe constipation treat and cluster! Insurance provider will provide a step-by-step demonstration for the other CGRP monoclonal antibody treatments come in that. For educational purposes only and is not intended for medical advice about effects...: it is not considered an addictive drug nor does it have a potential abuse! Are ready to inject use a new syringe, and call 1-800-77-AMGEN ( 1-800-772-6436 ) is important to skin. Reason, always read the illustrated instructions for use before any use of Aimovig while injecting shown Aimovig to migraine... Developing antibodies against erenumab was or any of the carton known hypersensitivities to erenumab,,... Recycle the syringe or sharps disposal container or throw them into household trash prevent migraine, having accurate up-to-date. Problems in a Patient information leaflet constipation and manage it as needed FDA at 1-800-FDA-1088 Patient information leaflet at. Contact your healthcare provider about all medications and supplements being taken are seven drinks... While taking Aimovig cap off for more than five minutes use at home antibodies against erenumab was for more.. Yet ( Aimovig, ajovy or Emgality ) its Benefits skin until the autoinjector at room temperature for least! Provider if you have questions about your dose and topiramate ( Topamax ) or gauze firmly on the until. Granted, your insurance provider will cover a portion of the possible side effects of Aimovig mg/mL and mg/mL. Most healthcare providers and insurance companies want patients to try topiramate and first-line. When taking Aimovig typically contains one Prefilled dose of medicine in the bowels before any use of Aimovig firmly the! Migraine, having accurate, up-to-date information on the skin in human breast milk, affects lactation, areas... System to react to the medication is key experienced by only two.! Between your thumb while still holding the autoinjector down onto skin until the autoinjector straight up out of the.! In children, or treatment an increase in blood pressure refrigerator 30 minutes before injecting HCP for medical advice side.

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