Self Injection Guide

Subcutaneous Injections (Sub-Q)

All GLP medications are given subcutaneously. A subcutaneous injection is a shot given into the fat layer between the skin and muscle. Subcutaneous injections are used to give very small amounts of medicine.

About the Syringe

There are 3 parts to a syringe: the needle, the barrel, and the plunger. The needle goes into your skin. The barrel holds the medicine and has markings on it like a ruler. The plunger is used to get medicine into and out of the syringe. We typically request insulin syringes. These hold a maximum of 1 mL of medicine. The syringe has markings from 10 to 100. The marking at 100 is the same as 1 mL. The marking at 50 is the same as 0.5 mL.

How to Draw Up the Medication

First, look carefully at the instructions listed on your medication as well as on your Rx Summary. You will be pulling up the medication by units. For example, you may be pulling up 25 units of tirzepatide which is a dose of 2.5mg.

It is very important to clean your vial top with an alcohol wipe (or isopropyl alcohol/gauze) before each use to maintain the sterility of your medication. Let it dry completely before puncturing the vial. When you are ready to draw the medication into the syringe, hold the syringe in your hand with the needle pointed up. With the cap still on, pull back the plunger to the line on your syringe for your dose. This fills the syringe with air. For example, if you need 25 units of medicine, pull the plunger to the line halfway between 20 and 30 on the syringe (pictured below). Next, remove the cap and insert the needle into the rubber top of the vial. Do not touch or bend the needle. Depress the plunger and push the air into the vial. This keeps a vacuum from forming so that the medicine will flow easily into the syringe. Turn the vial upside down and hold it up in the air. Make sure that the medicine covers the tip of the needle the entire time. As you did before, pull back the plunger to the line on your syringe for your dose. Remove the needle from the vial. The medicine is ready to inject.

Where To Give the Injection

➔ Abdomen: Uncover your abdomen. You may give an injection within the following area: below the waist to just above the hip bone and from the side to about 2 inches from the belly button. Avoid the belly button.

➔ Thigh: Uncover the entire leg. Find the area halfway between the knee and hip and slightly to the side. Gently grasp the area to make sure you can pinch 1 to 2 inches of skin.

➔ Upper Arm (requires a helper): Uncover the arm to the shoulder. Have the person receiving the injection stand with their hand on their hip. Stand next to and a little behind the person. Find the area halfway between the elbow and shoulder. Gently grasp the skin at the back of the arm between your thumb and first 2 fingers. You should be able to grasp 1 to 2 inches of skin.

How to Choose the Best Place

Keep track of where the injections are given. Write down the date, time, and the site each time you give an injection.

➔ Change sites for the injections: It is important to use a different site each time you give an injection. This prevents scars and skin changes. The sites where injections are given should be at least 1 inch away from each other.

What You Need

●  Syringe with medication

●  One alcohol wipe

●  One sterile 2 x 2 gauze pad or bandaid

How to Give the Injection

Subcutaneous injections can be given straight in at a 90 degree angle or at a 45 degree angle. Give the injection at a 90 degree angle if you can grasp 2 inches of skin between your thumb and first finger. If you can grasp only 1 inch of skin, give the injection at a 45 degree angle.

1. Open the alcohol wipe: Wipe the area where you plan to give the injection. Let the area dry. Do not touch this area until you give the injection.

2. Prepare the needle: Hold the syringe with your writing hand and pull the cover off with your other hand. Place the syringe between your thumb and first finger. Let the barrel of the syringe rest on your second finger.

3. Grasp the skin: With your other hand, grasp the skin.

4. Insert the needle into the skin: Hold the syringe barrel tightly and use your wrist to inject the needle
   into the skin. Once the needle is all the way in, push the plunger down to inject the medicine.

5. Pull out the needle: Remove the needle at the same angle you put it in. Gently wipe the area with the
   gauze pad or place your bandaid.

How do I get rid of used syringes and needles?

It is important to dispose of the needles and syringes correctly. Do not throw needles into the trash. You may receive a hard plastic container made especially for used syringes and needles. You can also use a soda bottle or other plastic bottle with a screw lid. Make sure that both the syringe and needle fit into the container easily and cannot break through the sides.

READING YOUR VIAL/VERIFYING ORDER AMOUNTS

We often get questions about the total amount of medication you receive in an order. Please note that the concentration (or strength) listed is not the total mg amount of medication in the vial. The concentration will vary by pharmacy. Be sure to always read your label and the instructions carefully with each new order.
Please note that the vial will often look barely full. This is to be expected as you are injecting fractions of a drop each week as the medicine is extremely potent at small amounts. This is why we strongly recommend keeping track of how much you inject each week as you will not be able to simply look at the vial to see how much you have left.

To calculate the total mg amount in each vial you must multiply the vial volume by the concentration dose per 1 milliliter.
In the picture above, the concentration is 5mg/0.5mL, meaning there are 5mg of medication in each half milliliter of medication. Therefore, each 1 milliliter contains a 10mg dose of medication (10mg/mL) The vial pictured above has a total volume of 2mL
2mL x 10mg/mL = 20mg vial

Examples:
Example 1 (Tirzepatide starter)
The vial label may read a concentration of 5mg/0.5mL (meaning there are 5mg of medication in each half milliliter of medication)
If you received 1 vial of medication which contains 1mL and 2 vials of medication that contain 2mL, you have a total of 50mg of medication 

To break that down,
1 vial with 1 mL
Each half mL contains 5mg, so every 1mL contains 10mg
1mL x 10mg = 10mg

PLUS

2 vials with 2 mL
Each half mL contains 5mg, so every 1mL contains 10mg
2 vials x 2mL x 10mg = 40mg

10mg + 40mg = 50mg total

Example 2 (Tirzepatide w/ B12 5mg weekly - 2 month supply)

The vial label may read a concentration of 10mg/mL (meaning there are 10mg of medication in each milliliter of medication)
If you received 2 vials of medication which each contain 2 mL, you have a total of 40mg of medication

To break that down,
2 vials with 2 mL each = 4 mL total
Each mL contains 10mg
4mL x 10mg = 40mg total

Example 3 Semaglutide Starter

The vial label may read a concentration of 2.5mg/mL (meaning there are 2.5mg of medication in each milliliter of medication).
If you received 2 vial of medication which each contain 1mL, you have a total of 5mg of medication 

To break that down,
2 vials with 1 mL each = 2mL total
Each mL contains 2.5mg
2mL x 2.5mg = 5 mg total

If you need any further help or assistance, please reach out to us via email at

patientsupport@lavenderskyhealth.com