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SOMAVERT® (pegvisomant) Instructions For Use


SOMAVERT® (SOM-ah-vert)
for injection, for subcutaneous use

Read these Instructions for Use before you start using SOMAVERT and each time you get a refill. There may be new information. This leaflet does not take the place of talking to your healthcare provider about your medical condition or your treatment. Your healthcare provider should show you or a caregiver how to inject SOMAVERT the right way before you inject it for the first time.


  • Do not share your SOMAVERT syringes or needles with other people. You may give other people a serious infection, or get an infection from them.
  • SOMAVERT comes in a vial as a white block of powder. You must mix SOMAVERT with a liquid (diluent) before you can use it. The liquid comes in a single-dose pre-filled syringe labeled 'Sterile Water for Injection'. Do not use any other liquid to mix with SOMAVERT.
  • You must use the mixed SOMAVERT within 6 hours after you mix it. If you have not used the mixed SOMAVERT within 6 hours, throw the SOMAVERT away.

Step 1. Things you need

A single SOMAVERT pack containing:

  • A vial of SOMAVERT powder.
  • A pre-filled syringe.
  • A safety needle.

You will also need:

  • A cotton ball.
  • An alcohol swab.
  • A sharps disposal container. See "Dispose" at the end of these instructions.

Step 2. Getting ready

Before you start:

  • Only mix SOMAVERT and the liquid when you are ready to inject your dose.
  • Remove a single SOMAVERT pack from the refrigerator and allow it to come to room temperature in a safe place at least 10 minutes before you need to use it.
  • Do not heat the SOMAVERT pack by using a heat source such as hot water or microwave. Let it warm up on its own.
  • Wash your hands with soap and water, and dry completely.
  • Peel open the packaging of the syringe and safety needle to make it easier to pick up each item as you prepare for your injection.
  • Do not use the syringe or vial if:
    • they are damaged or faulty
    • the expiration date has passed
    • it has been frozen, even if it has now thawed (syringe only)

Step 3. Choose injection area

  • Choose a different location within an area for each injection.
  • Avoid bony areas or areas that are bruised, red, sore or hard, or areas that have scars or skin conditions.
  • Clean the injection area with the alcohol swab as instructed by your healthcare provider.
  • Allow the injection area to dry.

Step 4. Remove vial cap

  • Remove the cap from the vial.
  • Throw the cap away. It is not needed again.
    Caution: Do not let anything touch the vial stopper.

Step 5. Remove syringe cap

  • Snap off the syringe cap leaving the syringe collar in place. It may take more effort to snap off than you might expect.
  • Throw the syringe cap away. It is not needed again.
  • Keep the syringe upright to avoid leakage.
    Caution: Do not let the end of the syringe touch anything when the syringe cap is off.

Step 6. Attach safety needle

  • Push down and twist the safety needle firmly onto the syringe as far as it will go.

Step 7. Remove needle cover

  • Fold the needle guard out of the way of the needle cover.
  • Carefully pull the needle cover straight off.
  • Throw the needle cover away. It is not needed again.
    Caution: Do not let the needle touch anything.

Step 8. Insert needle

  • Push the needle through the center of vial stopper, as shown.
  • Support the syringe while the needle is in the vial stopper to prevent bending the needle.

Step 9. Add liquid

  • Tilt both the vial and syringe at an angle, as shown.
  • Push the plunger rod down slowly until all the liquid has emptied into the vial.
  • Caution: Do not squirt the liquid directly onto the powder. This creates foam. Foam makes the medicine unusable.
  • Do not withdraw the needle yet.

Step 10. Swirl vial

  • Support both the syringe and vial in 1 hand, as shown.
  • Gently and slowly swirl the liquid, sliding the vial in a circular motion on a flat surface.
  • Continue swirling the liquid until all the powder has fully dissolved.
    Note: This may take up to 5 minutes.
    Do not shake.

Step 11. Check medicine

  • Keeping the needle in the vial, look carefully at the medicine. It must be clear and free of particles.
  • Do not use if:
    • the medicine is cloudy or hazy
    • the medicine has any color at all
    • there are any particles or foam in the vial
  • If you have any doubts about your medication go to or call 1-800-645-1280.

Step 12. Reposition needle

  • Turn the vial so that you can see the stopper gap, as shown.
  • Pull the needle down so that the needle tip is at the lowest point in the liquid. This will help you to draw off as much liquid as possible.
  • Check that the plunger rod has not moved. If the plunger rod has moved, then push it back all the way into the syringe. This ensures that all air is removed from the syringe before you draw off the dose.

Step 13. Draw off dose

  • Slowly pull back the plunger rod to withdraw as much medicine as possible from the vial.
    Note: If you see air in the syringe, tap the barrel to float the bubbles to the top, and then gently push the bubbles out into the vial.
  • Pull the needle out of the vial.

Step 14. Insert needle

  • Gently pinch the skin at the site of injection.
  • Insert the needle to its full depth into the pinched skin.

Step 15. Inject medicine

  • Push the plunger rod down slowly until the barrel is empty.
    Note: Make sure you keep the needle in at full depth.
  • Release the pinched skin and pull the needle straight out.

Step 16. Make needle safe

  • Fold the needle guard over the needle.
    Gently apply pressure using a hard surface to lock the needle guard in place.
  • Note: You will hear a click when the needle guard has been locked.

Step 17. Dispose

  • Put your used syringes in a FDA cleared sharps disposal container right away after use.
  • Do not throw away (dispose of) syringes in your household trash.
    Note: If you do not have a FDA cleared sharps disposal container, please refer to the safe syringe disposal information on the right hand side of this leaflet.

Step 18. After injection

  • If necessary, use a clean cotton ball and press lightly on the injection area.
  • Do not rub the area.


What should I do if anything has accidentally touched the vial stopper?

  • Clean the vial stopper with a fresh alcohol wipe, and leave it to dry completely. If you are unable to clean the stopper, do not use the vial.

What should I do with the syringe if it has been dropped?

  • Do not use it even if it looks undamaged. Dispose of the syringe in the same way as a used syringe. You will need a replacement syringe.

How many times can I safely insert the needle into the vial stopper?

  • Only 1 time. Withdrawing and reinserting greatly increases the risk of needle damage, and will blunt the needle. This can cause discomfort and increases risk of skin damage and infection. There is also a risk you may lose some of the medicine.

Is it okay to shake the vial if the powder is not dissolving?

  • No. Never shake the vial. Shaking can destroy the medicine and create foam. The powder may take a few minutes to dissolve fully, so continue swirling the vial gently until the liquid is completely clear.

How can I tell if there is any foam in the vial?

  • Foam looks like a mass of small bubbles that float as a layer to the top of the liquid. Do not inject SOMAVERT if it has foamed.

How can I prevent the medicine from foaming?

  • Press the plunger very slowly so that the liquid gently runs down the inside of the vial. Do not spray the liquid directly onto the powder, because this creates foam. This will also reduce the swirling time and allow more of the medicine to be drawn off.

I can see some air in the syringe. Is this okay?

  • Tiny air bubbles in the liquid are normal and are safe to inject. However, it is possible to accidently draw air into the syringe, which should be removed before injecting. Bubbles or air gaps that float to the top of the liquid should be pushed back out into the vial.

Why can I not get all of the medicine out of the vial?

  • The shape of the vial means that a very small amount of the medicine will be left behind in the vial. This is normal. To ensure that only a trace of medicine remains, make sure the needle tip is as low as it can be in the vial when drawing off your dose.

What should I do if I have any doubts about my medicine?

  • For more information, go to or call 1-800-645-1280.

Safe syringe disposal information

If you do not have a FDA-cleared sharps disposal container, you may use a household container that is:

  • made of heavy-duty plastic,
  • can be closed with a tight-fitting, puncture-resistant lid, without sharps being able to come out,
  • upright and stable during use, leak-resistant, and
  • properly labeled to warn of hazardous waste inside the container.

When your sharps disposal container is almost full, you will need to follow your community guidelines for the right way to dispose of your sharps disposal container. There may be state or local laws about how you should throw away used needles and syringes.

For more information about safe sharps disposal, and for specific information about sharps disposal in the state that you live in, go to the FDA's website at:

This Instructions for Use has been approved by the U.S. Food and Drug Administration.


Revised: April 2016

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