For Patients & Caregivers

Flexibility of subcutaneous self-administration1

Patients can self-inject ENSPRYNG® after proper training1

Help your patients get started on ENSPRYNG

ENSPRYNG is intended to be self-administered under the guidance of a healthcare provider. After proper training and approval from a healthcare provider, your patients can self-administer treatment with ENSPRYNG.1

Discover some helpful tips for your patients to self-administer ENSPRYNG:

For a full-step-by-step guide, please ask your patients to follow the Instructions for Use.

Step 1

Take the box containing your ENSPRYNG syringe out of the refrigerator, where it was stored at 36°F to 47°F (2°C to 8°C).

Always check that the medicine and dose match the prescribed treatment.

Check the expiration date on the back of the box and the seal on the front of the box. If the date is past or the seal is broken, do not use. Dispose of the syringe per the Instructions for Use and contact your healthcare provider.

Step 2

Open the box. Gently lift the syringe by the barrel and pull it out.

Check the expiration date on the syringe. The liquid should be clear and colorless to pale yellow. Some small bubbles are normal. 

If the syringe is damaged or expired, or the liquid is cloudy, discolored, or has particles in it, do not use.

Step 3

Place the syringe on a clean, flat surface, set a timer for 30 minutes and let it come to room temperature. Keep it away from heating sources; do not warm up the syringe in direct sunlight, in a microwave, or with hot water. Do not remove the needle cover while the syringe is reaching room temperature.

Step 4

While waiting, gather the supplies needed for the injection: 1 alcohol pad, 1 sterile cotton ball or gauze, 1 small bandage and 1 FDA-cleared, puncture-resistant sharps container for safe disposal of the needle cap and used syringe.

Step 5

First, wash the hands with soap and water.

Next, choose an injection site: the front or middle of the thighs, or the lower part of the stomach.

Do not inject into moles, scars, bruises or areas where the skin is tender, red, hard or broken. The site should not be within 2 inches of the belly button.

The injection site must be at least 1 inch away from the previous injection site.

Wipe the injection site with an alcohol pad. Let it air dry, and do not touch it.

If assistance with the injection is needed, a trained caregiver can assist.

Step 6

Do not take the needle cap off until ready to inject ENSPRYNG.

Take the cap off the needle and immediately dispose of it in an FDA-approved sharps disposal container. Do not put the needle cap back on after it has been removed as this may damage the needle.

Hold the barrel of the syringe using the thumb and index finger.

Use the syringe within 5 minutes, or the needle may clog. Do not touch the needle or let it touch any surfaces. Keep it away from children.

To check for air bubbles, hold the syringe with the needle pointing up. If there are any air bubbles, gently tap the syringe with a finger until the bubbles rise to the top. Slowly push the plunger rod just until all air is expelled from the syringe and needle, and a drop of drug solution is seen at the needle tip.

Step 7

Hold the barrel of the syringe using the thumb and index finger. Do not insert the needle through clothing. With the other hand, pinch the area of the skin you have cleaned. Use a quick, dart-like motion to insert the needle at an angle between 45 to 90 degrees. Insert the needle only once. Do not change the angle of the injection.

Step 8

Let go of the pinched skin. Then slowly inject the medicine by gently pushing the plunger all the way down. Gently release the plunger and allow the needle to come out of the skin at the same angle it was inserted. The needle shield should now cover the needle. If not, take extra care when disposing.

Step 9

Check the injection site. A small amount of blood or a drop of medicine may appear. If needed, press a cotton ball or gauze on it, but do not rub it. The site can be covered with a small bandage if needed. If the medicine comes in contact with the skin, wash with water.

Step 10

Immediately place the used ENSPRYNG syringe in an FDA-approved sharps disposal container, not in your household trash, per the Instructions for Use.

If an FDA-cleared container isn't available, use a household container that is:

  • Heavy-duty plastic and leak-resistant
  • Upright and stable during use
  • Securely sealed with a tight, puncture-resistant lid
  • Clearly labeled as hazardous waste

Over time the container will fill up, so make sure to dispose of the used sharps disposal container as instructed by a healthcare provider, pharmacist or community guidelines.

Never recycle the container, and only place it in household trash if explicitly allowed by local rules. Visit www.fda.gov/safesharpsdisposal for state-specific regulations and safety information.

Dosing1

ENSPRYNG is available as a 120 mg/mL prefilled syringe, and will be available as a 120 mg/mL autoinjector and 180 mg/1.5 mL autoinjector in early 2027.

In the clinical trials, patients received a total of 7 doses of ENSPRYNG.1

*Time of first administration.
†Dosing is based on actual body weight.

The safety and effectiveness of ENSPRYNG has not been established in TED patients weighing <40 kg.1

In case of a missing dose:1

Time since last dose

Recommended dosage for delayed or missed doses

<8 weeks during the maintenance period or missed a loading dose

Administer the recommended dose by subcutaneous injection as soon as possible, and do not wait until the next planned dose.

Maintenance period

  • After the delayed or missed dose is administered, reset the dose schedule to every 4 weeks

Loading period

  • If the 2nd loading dose is delayed or missed, administer as soon as possible and administer the 3rd and final loading dose 2 weeks later
  • If the 3rd loading dose is delayed or missed, administer as soon as possible and administer the 1st maintenance dose 4 weeks later

8 weeks to <12 weeks

Administer the recommended dose by subcutaneous injection at 0‡ and 2 weeks, followed by the recommended dose every 4 weeks

≥12 weeks

Administer the recommended dose by subcutaneous injection at 0‡, 2 and 4 weeks followed by the recommended dose every 4 weeks

‡Time of first administration after the missed dose.

Storage and handling1

Refrigerate at 36°F to 46°F (2°C to 8°C) in original carton to protect from light. Do not freeze and do not shake.1

ENSPRYNG can remain stable at room temperature (not to exceed 86°F/30°C) for a total of 8 days.1

FDA=Food and Drug Administration; Q4W=every 4 weeks; SC=subcutaneous; TED=thyroid eye disease.

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Safety

Discover a well-established safety profile.1

Learn more
Next: Patient monitoring

Important Safety Information & Indication

Indication

ENSPRYNG® (satralizumab-mwge)  is indicated for the treatment of thyroid eye disease (TED) regardless of TED activity or duration in adult patients.

Contraindications

ENSPRYNG is contraindicated in patients with a known hypersensitivity to satralizumab or any of the inactive ingredients, an active hepatitis B infection, or active or untreated latent tuberculosis.

Warnings and Precautions

Infections
An increased risk of infections, including serious and potentially fatal infections, has been observed in patients treated with IL-6 receptor antagonists, including ENSPRYNG. The most common infections reported in a randomized clinical trial of patients treated with ENSPRYNG who were not on other chronic immunosuppressant therapies, and that occurred more often than in patients receiving placebo, were nasopharyngitis (12%) and cellulitis (10%). The most common infections in patients who were on an additional concurrent immunosuppressant, and that occurred more often than in patients receiving placebo, were nasopharyngitis (31%), upper respiratory infection (19%), and pharyngitis (12%). Delay ENSPRYNG administration in patients with an active infection, including localized infections, until the infection is resolved.

Hepatitis B Virus (HBV) Reactivation
Risk of HBV reactivation has been observed with other immunosuppressant therapies. Patients with chronic HBV infection were excluded from clinical trials. Perform HBV screening in all patients before initiation of treatment with ENSPRYNG. Do not administer ENSPRYNG to patients with active hepatitis. For patients who are chronic carriers of HBV [HBsAg+] or are negative for HBsAg and positive for HB core antibody [HBcAb+], consult liver disease experts before starting and during treatment with ENSPRYNG.

Tuberculosis
Tuberculosis has occurred in patients treated with other IL-6 receptor antagonists. Patients should be evaluated for tuberculosis risk factors and tested for latent infection prior to initiating ENSPRYNG. Consider anti-tuberculosis therapy prior to initiation of ENSPRYNG in patients with a history of latent or active tuberculosis in whom an adequate course of treatment cannot be confirmed, and for patients with a negative test for latent tuberculosis but having risk factors for tuberculosis infection. Consult infectious disease experts regarding whether initiating anti-tuberculosis therapy is appropriate before starting treatment. Patients should be monitored for the development of signs and symptoms of tuberculosis with ENSPRYNG, even if initial tuberculosis testing is negative.

Vaccinations
Live or live-attenuated vaccines should not be given concurrently with ENSPRYNG because clinical safety has not been established. Administer all immunizations according to immunization guidelines at least 4 weeks prior to initiation of ENSPRYNG for live or live-attenuated vaccines and, whenever possible, at least 2 weeks prior to initiation of ENSPRYNG for non-live vaccines.

Elevated Liver Enzymes
Mild and moderate elevations of liver enzymes have been observed in patients treated with ENSPRYNG at a higher incidence than in patients receiving placebo. ALT and AST levels should be monitored every 4 weeks for the first 3 months of treatment, followed by every 3 months for one year, and thereafter, as clinically indicated.

Decreased Neutrophil Counts
Decreases in neutrophil counts were observed in patients treated with ENSPRYNG at a higher incidence than placebo. Neutrophil counts should be monitored 4 to 8 weeks after initiation of therapy, and thereafter at regular clinically determined intervals.

Hypersensitivity Reactions
Hypersensitivity reactions, including rash, urticaria, and fatal anaphylaxis, have occurred with other IL-6 receptor antagonists.


Use in Specific Populations

Pregnancy
There are no adequate data on the developmental risk associated with the use of ENSPRYNG in pregnant women. In an animal reproduction study, no adverse effects on maternal animals or fetal development were observed in pregnant monkeys and their offspring, with administration of ENSPRYNG at doses up to 50 mg/kg/week. In the U.S. general population, the estimated background risk of major birth defect and miscarriage in clinically recognized pregnancies is 2 – 4% and 15 – 20%, respectively. The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. ENSPRYNG should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus.

Lactation
No information is available on the presence of ENSPRYNG in human milk, the effects of ENSPRYNG on the breastfed infant, or the effects of ENSPRYNG on milk production. ENSPRYNG was excreted in the milk of lactating monkeys administered ENSPRYNG throughout pregnancy. Human IgG is excreted in human milk and the potential for absorption in the infant is unknown. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for ENSPRYNG and any potential adverse effects on the breastfed infant from ENSPRYNG or from the underlying maternal condition.

Pediatric Use
Safety and effectiveness in pediatric patients have not been established.

Geriatric Use
Clinical studies of ENSPRYNG did not include sufficient numbers of patients aged 65 years and older to determine whether they respond differently from younger patients. However, population pharmacokinetic analyses in patients with NMOSD did not show that age affected the pharmacokinetics of ENSPRYNG. In general, caution should be used when dosing the elderly, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant diseases or other drug therapy.

Most Common Adverse Reactions
The most common adverse reactions in patients with TED (incidence ≥5% and greater than placebo) were upper respiratory tract infection (5%), and alanine aminotransferase increased (5%).

You may report side effects to the FDA at (800) FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at (888) 835-2555.

For additional safety information, please see the full Prescribing Information and Medication Guide.

    • ENSPRYNG [package insert]. South San Francisco, CA: Genentech, Inc; 2026.

      ENSPRYNG [package insert]. South San Francisco, CA: Genentech, Inc; 2026.

    • Subramanian P, et al. Presented at North American Neuro-Ophthalmology Society (NANOS) 52nd Annual Meeting. March 20-24, 2026.

      Subramanian P, et al. Presented at North American Neuro-Ophthalmology Society (NANOS) 52nd Annual Meeting. March 20-24, 2026.

    • Bennett JL, et al. Neurol Neuroimmunol Neuroinflamm. 2025;12(5):e200450.

      Bennett JL, et al. Neurol Neuroimmunol Neuroinflamm. 2025;12(5):e200450.

    • Murdock J, et al. Front. Ophthalmol. 2025; 5:1544436.

      Murdock J, et al. Front. Ophthalmol. 2025; 5:1544436.

    • Ezra DG, et al. Rev Endocr Metab Disord. 2026; 27(2):237-253.

      Ezra DG, et al. Rev Endocr Metab Disord. 2026; 27(2):237-253.

    • Ezra DG, et al. Ophthalmol Ther. 2025; 14(12):3119-3132.

      Ezra DG, et al. Ophthalmol Ther. 2025; 14(12):3119-3132.

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