Subcutaneous Injection
As the name implies, the goal of subcutaneous injections is to deliver medication into the layer of subcutaneous fat just under the skin.
Please read and be familiar with all steps before proceeding with an injection. If you have any questions or concerns, message your provider through the patient portal.
Collect
Collect all the supplies you will need for the injection:
- • Medication vial
- • Alcohol wipes (2)
- • Syringe
- • Drawing needle (larger needle)
- • Injection needle (smaller needle)
- • Sharps container
Clean
Your syringes and needles should be new and still in sterile factory packaging. Wash your hands with soap and water for at least 20 seconds. Use one alcohol wipe to sanitize the top of the medication vial. Use one alcohol wipe to clean the skin over your chosen site of injection. When cleaning your skin use circular motions several times directly over the site of injection and then moving outward in larger circles until at least a 2-inch diameter area has been cleaned. Make sure to let the medication vial and your skin air dry completely.
Fill
How you fill the syringe depends on your medication. Oil-based preparations (such as testosterone) are thicker and need a needle change. Water-based preparations (such as most peptides) are thin enough to draw and inject with a single small syringe. Follow the path that matches your medication.
e.g. testosterone
- 1. Put the drawing needle (the larger of the two) on the syringe without touching near the connection point. Pull the plunger back to your prescribed dose to load that much air.
- 2. Push the needle through the rubber top of the vial, inject the air, then flip the vial upside down and draw past your dose. Push back down to about 2 units over your prescribed dose. That extra accounts for the small amount lost in the new needle.
- 3. With the draw needle still on, pull a little air back into the syringe to clear the oil from inside it, then switch to the injection needle (the smaller one). This keeps that oil from going to waste.
- 4. Hold the syringe needle-up, flick out any bubbles, and press the plunger until a drop appears at the tip.
e.g. most peptides
- 1. Use your insulin or peptide syringe. No needle change is needed.
- 2. Pull the plunger back to your dose to load that much air, push the needle through the rubber top of the vial, and inject the air.
- 3. Flip the vial upside down and draw to your dose. Overfill slightly, then push back to land exactly on your prescribed dose.
- 4. Hold the syringe needle-up, flick out any bubbles, and press until a drop appears at the tip. Inject from this same syringe.
Inject
The most important part of injecting medication is to find a spot that doesn't have many nerves or blood vessels by it. To easily complete subcutaneous injections you need to be able to pinch 1-2 inches of skin. Good subcutaneous injection sites include the upper arm, abdomen, love handle, and thigh.
Typically easiest in the middle of the arm halfway between the shoulder and the elbow. There is usually more skin towards the back of the arm so this location may require the help of a partner.
Area around the middle of the abdomen where most of the "Dad bod" fat is. Stay at least two inches away from your belly button (navel).
Area of fat that collects above your belt-line on the sides of your body.
Divide your thigh into thirds from the hip down to the knee. Anywhere in the middle third where you can grab enough skin for injection.
Tip: Experiment with your injection site. Everyone is different and depending on your body some areas will be easier and less painful than others.
Tip: Vary your injection locations to avoid scar formation; small variations in the same region, side to side, and in a different region all together.
- 1. Pinch 1-2 inches of skin using the hand that won't be doing the injection.
- 2. Holding the barrel of your syringe like you would a dart, quickly push the needle through the skin until it reaches the colored base. If you can only pinch 1 inch of skin, enter the skin at a 45° angle. If you can pinch 2 inches of skin (preferred), enter at a 90° angle.
- 3. Inject the medication into the subcutaneous fat at a moderate and even pace.
- 4. Withdraw the needle quickly and prepare to dispose.
Tip: The slower and more hesitant you are the more painful inserting the needle will be. If you are fast and confident you probably won't feel it at all.
Tip: Stabilize your syringe once the needle is in by resting your hand on your body.
Tip: This should not be very painful. If the placement of the needle or the injection of medication is more painful than previous injections, STOP. Withdraw the needle, place a new injection needle on the syringe, and move to a slightly different area. Sometimes a few millimeters will make all the difference.
Dispose
Separate the draw and injection needle from the rest of your waste. You can place the needles in a purchased "Sharps Container," which you can typically get from a local pharmacy or an online retailer. If you don't want to buy one, you can use any old hard plastic container you have at home such as an empty 2L soda bottle or laundry detergent container. If you use a home-made container, label the outside with the words "Sharps Waste". Disposal of full containers varies by county. In Thurston County the sealed sharps container can be placed in your regular trash can. Never place sharps directly into the trash.
For clinical questions, message your provider through the patient portal. This handout is a reference and does not replace direct medical guidance.