Your first injection, step by step

General information about the equipment, not medical advice. The directions that came with your medicine and the person who prescribed it come first, every time.

What this page is and is not

This describes the equipment and the order things happen in. It does not tell you where to inject, how much, or how often, because those depend entirely on the medicine and on you, and they come from the person who prescribed it and from the leaflet in the box.

If you have been handed a script and nobody walked you through the practical side, that is worth a phone call to the prescribing clinic or a pharmacist. Most will talk you through it, and many will do it in person the first time. It is a normal thing to ask for.

Before you start

Clear a surface and wash your hands properly. Lay out what you need so you are not hunting for something mid way: the medicine, the syringe or pen needle, an alcohol swab, something clean to hold over the site afterwards, and the sharps container open and within reach.

Check the medicine. Look at the expiry, look at the liquid, and read the label to confirm it is what you think it is and at the concentration you think it is. If it looks cloudy when it should be clear, or has anything floating in it, do not use it.

Let it come to room temperature if it has been refrigerated and the directions say to. Cold liquid stings more going in. How long that takes is on the leaflet.

Drawing up, if you are using a syringe

Swab the rubber stopper on the vial and let it dry. The alcohol does its work as it evaporates, so wiping it off straight away defeats the purpose.

Draw air into the syringe to match the volume you are taking out, push it into the vial, then invert and draw. The air replaces the liquid you remove and stops a vacuum forming, which is what makes a vial fight you.

Tap the barrel to bring bubbles to the top and push them back into the vial. A small bubble in a subcutaneous injection is not the emergency the internet suggests, but it does mean you have less liquid than the scale says, which is the real reason to clear it.

If the liquid is thick, draw up with a wider blunt needle and swap to a finer one to inject. Never inject with a drawing-up needle.

Afterwards

The needle goes straight into the sharps container, immediately, without recapping it. Recapping is when most needlestick injuries happen. This is the one part of the process where the advice is the same for everyone.

A spot of blood is common and not a problem. Hold something clean over it rather than rubbing. If a site is hot, swollen, increasingly painful over the following days, or you feel unwell, that is a call to your prescriber rather than a thing to wait out.

Write down what you did and when, at least for the first few. It is much easier to have a useful conversation with your prescriber when you can answer questions about what actually happened.