2-Step Pre-filled Pen

Hulio® is an approved biosimilar of adalimumab and is available in 3 presentations, including an easy-to-use pre-filled pen for the patient’s convenience.

The pre-filled syringe and the pre-filled pen are made of durable plastic instead of glass, so as to avoid accidental breakage. Each pre-filled pen is for single use only and contains one 40-mg dose of adalimumab.

The components of the pre-filled pen include needle cap, orange activator and viewing window, which contains the medication, fill marker and orange indicator.

Before injection

The pre-filled pen should be stored in the refrigerator (2°C-8°C). A single pre-filled pen should be removed from the refrigerator at least 30 minutes before using it, so as to allow the contents to reach room temperature. The patient should wash hands thoroughly and set up a pre-filled pen of Hulio® and an alcohol pad on a clean surface.1

The patient should:

  • check for expiry date on the pen and not use the product if the date has expired
  • check the viewing window to ensure the medication is at or near the fill marker
  • check for the change in colour and particles in the solution. If the solution is frozen, cloudy or discoloured and has particles, then the pen has to be discarded1

During and after injection

Step 1 - Choose and prepare injection site

Hulio® pre-filled pen is for subcutaneous injection. It should be injected into the thigh or abdomen.

You should rotate and change your injection site each time, staying at least 3 cm from the previous site used.

If you are injecting into the abdomen, choose a site that is at least 5 cm away from the belly button.

  • DO NOT inject into skin that is red, hard, bruised, or tender.
  • DO NOT inject into scars or stretch marks.
  • If you have psoriasis, DO NOT inject into any raised, thick, red, or scaly skin patches, or lesions.
  • DO NOT inject through clothes. Roll back any clothing that may interfere with the injection site.

Step 2 - Wash hands

Wash your hands with soap and water.

Step 3 - Prepare injection site

Wipe the skin at the chosen injection site with an alcohol swab.

  • Wait for it to dry on its own, do not blow dry it.
  • DO NOT touch this area again before giving the injection.

Step 4 - Uncap pen

Pull the needle cap straight off the pen. A few drops of liquid may come out of the needle, this is normal. It is also normal to see air bubble(s).

  • DO NOT remove the needle cap until you are ready to inject.
  • Pull the needle cap straight off the pen, DO NOT twist the cap.
  • DO NOT re-cap or touch the needle with your fingers, or let the needle touch anything.
  • DO NOT touch the orange activator with your fingers (this is where the needle comes out).
  • DO NOT use the pen if it has been dropped onto a hard surface. Components inside the pen may be broken.
  • DO NOT use the pen if the needle cap is missing or not securely attached.

Step 5 - Squeeze & hold injection site

Gently squeeze the injection site to create a raised area, and hold that area firmly.

Step 6 - Place pen

Place the orange activator end of the pen onto the injection site.

Keep the pen held at a 90° angle to the injection site, and with the viewing window visible to you.

Be careful to place the pen so that it will not inject into your fingers holding the injection site.

Step 7 - Begin injection

Firmly push the body of the pen down against the injection site to engage the orange activator and begin the injection.

Continue holding down after hearing the 1st “CLICK”. This 1st “CLICK” signals the start of the injection.

In the viewing window, the orange indicator will advance to show the progress of the injection. DO NOT move, twist, or rotate the pen during injection.

Step 8 - Hold down for 2nd “CLICK” & 10 seconds

Continue holding the body of the pen down against the injection site until one, or all, of the following occur:

  • A 2nd “CLICK” is heard,
  • 10 seconds has passed,
  • orange indicator has stopped and completely blocked the viewing window.

Step 9 - End of injection, remove pen

Pull the pen straight away from injection site.

After injection, if slight bleeding occurs from the injection site, press a gauze pad or cotton ball lightly against the skin for a few seconds - DO NOT rub the injection site. If needed, cover the injection site with a plaster.

Step 10 - Dispose pen & cap

Dispose of the used pen and cap in an approved sharps disposal container.

Check with your healthcare provider for instructions on how to properly dispose of a filled sharps container.

  • DO NOT re-use the pen.
  • DO NOT re-cap the needle.
  • DO NOT throw the sharps container in your household bin.
  • DO NOT recycle your used sharps disposal container.

Always keep your sharps container out of the sight and reach of children.

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Report side effects

▼This medicine is subject to additional monitoring. This will allow quick identification of new safety information. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare providers are asked to report any suspected adverse reactions. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard. In order to support effective tracking and traceability of biologics including biosimilars, it is recommended that the brand name and batch number are recorded and used when reporting adverse events.

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