MetoJect® Disposal Programme Patient Instructions Procedure for MetoJect® Sharps Disposal Please read these instructions carefully You have been prescribed with Metoject® as part of your homecare regime. As this prescription requires administration of the drug at home it is important that the disposal of used needles and syringes is carried out in a responsible manner. To that end, a service is offered by Fannin to supply you with a suitable container to store used needles and syringes, which will periodically be disposed of by a licensed contractor, SRCL. The following instructions should be followed. The container supplied to you should be kept in a safe place in the home. Please keep the container out of the reach of children, if possible in a press that can be locked. Only Metoject® needles and used syringes should be placed in the container, through the small opening in the lid of the container. Remove the blue shoulder on the syringe prior to placing the needle/syringe in the sharps container. The container has a lockable twist lid. Please note that whilst in use the lid should only be twisted once to cover the opening. If the lid is fully twisted until it clicks the container will lock and you will be unable to open the container. This ‘full twist and click’ procedure should only be carried out when the container is full and requires disposal. Disposal of the full container will be carried out either by collection directly from your home or by an arrangement with the pharmacy that supplies your prescription – Note: Prior agreement with your pharmacist is required if this option is chosen. If you have such an arrangement with your pharmacist, you should return the full container to the pharmacy who will notify the licensed disposal contractor and arrange for collection. To arrange delivery of a replacement container, you should contact your pharmacist in advance. If collection is made from your home contact SRCL on 01 4659136 to arrange. A replacement container will be supplied to you at the time of collection Should you have any queries or require any further information please contact Customer Services at Fannin at 01 2907000. CSDF20 – MetoJect Sharp Bin Collection Form Rev2 MetoJect® Disposal Programme Pharmacist Information Procedure for Registration and Waste Collection Metoject® may be prescribed as part of homecare treatment for administration at home. It is therefore important that the disposal of used needles and syringes is carried out in a responsible manner. To that end, a service is offered by Fannin to supply a suitable container to store used needles and syringes which will periodically be disposed of by a licensed contractor, SRCL. The following instructions should be followed to register for this service: In consultation with your patient, complete the attached MetoJect Disposal form and return to Fannin Customer Service Department either by post or by fax. Fannin will then assign a MetoJect Reference Number and register the details for waste disposal collection with SRCL. Following registration, a cytotoxic sharps bin, labelled with the MetoJect Reference Number, will be delivered to the waste disposal point chosen. Disposal of the full container will be carried out by collection direct from the nominated pharmacy or home when requested. Replacement bins will be provided on day of collection or in advance on request. Note: Pharmacy collection only following prior agreement of the pharmacist. In the case of pharmacy collection, the patient should return the full container to the pharmacy. To arrange collection and advance delivery of a replacement container, telephone SRCL on 01 4659136, quoting the MetoJect reference number located on the side of the MetoJect sharps bin. A replacement container will be sent immediately by post. If the patient selects home collection, this will be carried out on request. A replacement container will be supplied at the time of collection Should you have any queries or require any further information please contact Customer Services at Fannin at 01 2907000. Fannin MetoJect® Disposal Programme Please return this form to Fannin House Customer Service Department South County Business Park Leopardstown Dublin 18 Tel Fax 01 2907000 01 2907111 This service is provided for Metoject® waste disposal only Please complete all compulsory sections of this form in full MetoJect® Waste Disposal Programme PLEASE COMPLETE THIS SECTION IN FULL PATIENT DETAILS ADDRESS 1 ADDRESS 2 TEL MOBILE PLEASE COMPLETE THIS SECTION IN FULL PRESCRIBING CONSULTANT NAME HOSPITAL NAME TEL FAX THIS SECTION IS ONLY TO BE COMPLETED IF OPTING FOR PHARMACY COLLECTION / DELIVERY PHARMACIST NAME PHARMACIST SIGNATURE DATE PHARMACY DETAILS ADDRESS 1 ADDRESS 2 TEL FAX PLEASE COMPLETE THIS SECTION AS DIRECTED Please tickthe relevant option/s below - If neither is required – please leave blank Please deliver MetoJect® sharps bin Please collect MetoJect® sharps bin NOTE If you have already received a MetoJect® sharps bin from your hospital or Point of Care Nurse - please note the MetoJect ID number here: MJ/______/_______ Fannin MetoJect® Disposal Programme Who provides and pays for the service The service is provided free of charge to you by SRCL, on behalf of Fannin the licensed distributor of MetoJect®. Responsibility for Storage Whilst the Sharps container is in my possesion I agree to store it responsibily and out of reach of children. Request for MetoJect® sharp bin container service I have read and understand the Metoject® Sharps container service leaflet. I am happy for a SRCL representative to contact me and call to my home for the purposes of the service. I hereby authorise Fannin / SRCL to hold and use my personal details for the purposes of providing me with the Metoject® Sharps container service both during and for a reasoanble time following my participation in the service, in accordance with its obligations under the data protection act 1998 and 2003. Signature Print Name Date Fannin