A patient administers interferon beta-1a SQ (Rebif) 22 mcg/0.5 mL 3 times each week. the patient calls the nurse to report unrelieved itching and erythema at the injection site, despite the use of topical hydrocortisone for several weeks. What will the nurse tell this patient to do?

A. Applying ice to the injection site before and after the injection is an effective, non-pharmacologic method to reduce local injection site reactions, such as erythema, itching, and swelling. Cooling the site reduces inflammation and numbs the area, providing relief without changing the medication regimen. B. Reducing the dose of interferon beta-1a is not recommended without a provider’s direct order and may compromise treatment efficacy. Dose adjustments are typically reserved for systemic adverse effects or intolerable reactions after consultation with the provider. C. Taking oral diphenhydramine (Benadryl) may relieve itching but is not the first-line intervention for local injection site reactions. It also carries risk of sedation and is unnecessary if non-pharmacologic measures are effective. D. Discussing prescription-strength hydrocortisone with the provider may be considered if topical measures fail, but the patient has already been using hydrocortisone without relief. Alternative strategies such as ice application should be tried first.