Patient education: How to give a subcutaneous injection (The Basics)

What is a subcutaneous injection? — A subcutaneous injection is a way to give medicine into the layer of fat right under the skin. "Subcutaneous" means "under the skin." "Injection" is another word for shot. You do this using a syringe with a small, short needle.

You might need to give yourself a subcutaneous injection because:

●Some medicines work better and faster when given this way.

●Some medicines need to be given into your body's fat.

●You are not able to take the medicine by mouth.

Where do I give a subcutaneous injection? — Your doctor or nurse will tell you where you can give the shot. This might be in the:

●Front or side of the belly – Make sure that the shot is at least 2 inches (5 cm) away from the belly button.

●Back part of the upper arm, between the elbow and shoulder

●Middle front or middle outside of the thigh, between the knee and hip

How do I give the shot? — Start by getting your supplies together:

●Wash and dry your hands.

●Get your medicine, syringe, and alcohol wipes. The syringe is the tube that holds the medicine before you inject it.

●Check that you have the right medicine.

●Check your medicine regularly to make sure that it is not expired. If you have any expired medicine, call your doctor, nurse, or pharmacy to get a refill.

Get the syringe ready:

●If you are using a prefilled syringe, you do not need to do anything to get it ready. If you see an air bubble in a prefilled syringe, this is OK. It helps to make sure that you get all of the medicine when you give the shot.

●If you need to fill the syringe (figure 1):

•Take the cap off of the bottle (vial) if it is new.

•Gently roll the bottle between your hands, but do not shake it.

•Clean the top of the bottle with an alcohol pad. Let it air dry.

•Pull the plunger of the syringe back until the tip is at the line showing the dose of medicine you need. This fills the syringe with air.

•Remove the cap from the needle.

•Push the needle into the rubber stopper on the bottle. Then, push the plunger so the air goes into the bottle.

•Turn the bottle with the syringe in it upside down, and hold the bottle with 1 hand. Pull back slowly on the plunger with your other hand to let the medicine into the syringe. Do this until the medicine reaches the line for the dose you need.

•Look at the medicine in the syringe. If you see any air bubbles, push the medicine back into the bottle and repeat the above step to fill the syringe. Repeat this until you do not see any air bubbles in the syringe. You can also gently tap the syringe to move the air bubbles toward the needle.

•Look at the color and appearance of the medicine in the syringe. Some medicines are clear and colorless. Others are cloudy. Be sure that you know if your medicine should be clear or cloudy. If you see any clumps or particles, do not use the medicine.

•Pull the needle straight out of the rubber stopper. Check again to make sure that you have the right dose.

•If you are not giving the shot right away, cover the needle with the cap before putting it down. Be careful not to poke yourself with the needle.

•Put your medicine away. Ask your doctor or pharmacist where you should store your medicine.

Give the shot (figure 2):

●Wash and dry your hands.

●Decide where to give the shot – Do not give the shot in the same place twice in a row. For example, if you gave your last shot in your upper thigh, give the next one in your belly or upper arm.

●If you usually have pain when giving the shot, you can hold an ice cube to your skin for a few minutes before giving it. Your doctor might be able to give you numbing cream to use on the area.

●Clean the skin with an alcohol wipe where you plan to give the shot. Let the skin dry fully. The alcohol helps to prevent infections. Pinch 1 to 2 inches (2.5 to 5 cm) of skin between your fingers and thumb on 1 hand.

●Holding the syringe firmly, and push the needle all of the way into the skin that you are pinching. Ask your doctor about the best angle for your medicine and needle size.

●Release the skin that you are pinching. Then, slowly press the plunger all of the way down.

●You might feel some discomfort and burning when the medicine goes in. Once all of the medicine is in, wait a few seconds. Then, remove the needle at the same angle that you put it in.

●Use a piece of gauze, and press gently on the area for about 5 seconds. If you see blood or clear fluid, press the area for another few seconds. Do not rub.

●Throw away the used needle and syringe in a special container made of thick plastic (picture 1). Do not throw needles away in the regular trash.

●Wash and dry your hands.

What else should I know? — You might have some bleeding, soreness, mild bruising, or redness where you gave yourself the shot. This is normal. Call your doctor if you have a lot of pain or other symptoms that worry you, or if you have trouble giving yourself the shot.

It is helpful to keep track of the where you gave a shot and what date and time. Write this down in a notebook, or use the notes app on your smartphone.

When should I call the doctor? — Call for an ambulance (in the US and Canada, call 9-1-1) if you have any signs of an allergic reaction. These can include:

●Hives or swelling of the face, eyes, or other parts of the body

●Trouble breathing or feeling like your throat is closing

●Vomiting or diarrhea

●Feeling dizzy or passing out

Call your doctor or nurse for advice if you:

●Are having side effects from your medicine

●Do not know how much medicine to give yourself

●Are not able to afford your medicine or supplies

●Have redness, warmth, or swelling where you gave the shot that does not go away

●Have trouble giving your injections, and would like more training