Information and instructions
WASH YOUR HANDS FIRST! Then place all items onto a clean, dry surface or on top of a clean piece of tissue.
STEP 1: Prepare needle
The sterile sharp needle is separate from the pre-filled syringe which holds the liquid. Although the liquid is already loaded into the syringe for you, you will still need to assemble the injection.
1.) TWIST (counter-clockwise) BLUE CAP OFF syringe tip:
2.) TWIST (clockwise) NEEDLE ONTO syringe tip:
3.) PULL OFF white plastic needle cap:
4.) Point needle towards ceiling and push out any extra air within syringe (optional).
5.) Set aside.
STEP 2: Prepare injection site
You will be injecting into either MUSCLE or FAT. Choose the area based on preference and comfort, there is no therapeutic difference between locations. DO NOT inject into a vein.
1.) Recommended sites for injection: ABDOMINAL FAT (into fat only) or THIGH MUSCLE (into muscle or fat):
2.) Clean the area with alcohol:
3.) Gently pinch and hold 1-2 inches of fat tissue around injection site, so the site is slightly raised:
STEP 3: Administer shot
It gets much easier after your first time. You can also have someone help you if you need.
1.) Hold injection like a pen, don’t touch plunger yet:
2.) Stick needle into the center of pinched injection site, STRAIGHT and ALL THE WAY in:
3.) Push plunger down at a steady comfortable rate until liquid is all gone:
4.) Pull out injection.
STEP 4: Clean up
- Clean, dress and put pressure gently on injection site to reduce bruising
- Dispose of needle in a proper sharps container (see Disposal instructions below)
- Put unused injections back into fridge (see Storage instructions below)
Tips and Tricks
- Abdominal injections tend to hurt less, but bruise more often.
- Thigh injections tend to hurt more, but bruise less often.
- Choose injection areas with larger, thicker parts of fat or muscle.
- Choose sites away from bruises, wounds, or visible blood vessels.
- Change different injection sites every time, choose a different site for your next injection.
- Sit and relax.
- Some people find a light massage of the area beforehand distracts the sensation of the injection.
- When sticking the needle in, hold the needle like a pen, then stick it in with a quick, dart-like motion.
- When sticking the needle in, push the whole needle in, injecting too close to the surface may active skin pain receptors.
- When injecting the liquid, do it slowly at a controlled, steady rate.
- Try to keep the needle as motionless and straight as possible while injecting.
- Have a cotton ball or tissue ready to press against the injection site afterward, then gently press on the location for at least 15 seconds to reduce the chance of bruising.
- A cool compress afterwards can reduce the sensation or soreness.
- Some people find slowly massaging and moving the muscle afterwards reduces the length of soreness afterwards.
Storage instructions
- Your injections are formulated to remain sterile and self-stable until the expiry date as long as you take care of it properly. Always check the expiry date before administering:
- Keep opened packs refrigerated. Store it in the refrigerator. If you need to bring it around, store it in a cooler.
- Do not freeze it. Do not allow it to freeze, or store it frozen.
- Keep it in the dark. Store it in a dark area. Do not let it sit in the sunlight.
- Keep it in an airtight container. Keep it sealed in the bag or another airtight container during storage. It will help prevent contamination.
- Keep it away from contamination. Don’t let it come in contact with foodstuffs or waste products. It will help prevent contamination.
- If you are ever unsure, discard injections that may have become compromised.
Disposal instructions
Needles MUST NOT be thrown into regular garbage bins, and must be disposed of in hard plastic containers or Sharps containers. You may be able to request one of these for free from any Shoppers Drug Mart. You can also use any hard plastic container that has a lid.
- Do NOT attempt to recap needles or twist the needle off the syringe. Dispose of the entire needle into Sharps container.
- Do NOT dispose of the needle into a regular waste bin or trashcan.
- Cotton, tissue, or other packaging can be disposed of into a regular waste bin.
- Try not to completely fill your Sharps container, replace it when it is about 3/4 full.
- When the Sharps container is full, close and seal the lid carefully and firmly.
- You can exchange your Sharps container at any pharmacy (i.e. Shoppers Drug Mart) for an empty container.
- You can also dispose of your Sharps container at the nearest Toronto Solid Waste Transfer Station at the Household Hazardous Waste Depot which will accept sharps drop-offs.
The Ontario Sharps Collection Program (OSCP) is a new stewardship program that promotes the safe and easy disposal of sharps from the public so that they aren’t disposed of in the garbage. The definition for sharps includes; infusion sets, safety pens and syringes with needles attached, lancets, needle tips, needles, pens, pen needles, pre-filled cartridges and pre-filled syringes.
For vials only
If you have a vial of liquid instead of pre-filled syringes, the procedure is the same as above except for the need to draw liquid into the syringe at the beginning. To do so:
- Clean the top of the vial with an alcohol wipe
- Attach the needle to the syringe
- Estimate how much liquid you need to draw into the syringe (e.g. 1 ml)
- Draw the corresponding volume of air into the syringe first (e.g. pull 1 ml air into empty syringe)
- Push needle into vial
- Invert the vial so it is vertically above the syringe
- Inject air into vial first (e.g. inject 1 ml air into vial)
- Draw the same volume of liquid into the syringe (e.g. pull 1 ml of liquid into syringe)
- Revert the vial so it is now directly below the syringe
- Pull syringe out
This will help to equalize the pressure in the vial so drawing medicine from the vial in the future won’t be too difficult.
FAQs
Expired, can I still use it?
No. It is not recommended you use expired injections.
Frozen, is it still usable?
Give it time to thaw to room temperature, then agitate the injection to re-mix all the ingredients. Do not heat your injectable to thaw. There will be no significant loss in sterility of the injection if it has been stored properly. However, freezing may cause separation of some of the ingredients from the liquid, and result in significant precipitation that does not dissolve back into liquid, at which point it may no longer be usable.
Liquid cloudy or precipitation?
As long as it have been stored properly, it should not affect the sterility of the injection. Shake the injection to mix the ingredients thoroughly. Sometimes injections will turn mildly cloudy or have some mild precipitation as it is stored for longer periods of time, or stored in less than ideal conditions.
Missed a dose?
If you miss a dose, resume the regular dosing schedule as soon as possible afterwards. If you miss too many doses in a row you may need an additional dose. Follow the instructions of your prescribing clinician as closely as possible. The typical dose is anywhere from 1-2 times per week. This is to ensure that the proper therapeutic levels of the vitamins remain in your bloodstream.
Not refrigerated, is it still usable?
As long as the injections have not been heated, they should remain useable. Refrigeration merely extends their shelf-life. There should be no significant loss in quality or sterility of the injection if it doesn’t happen too often. Refrigerate it again once you have the chance.
Redness or inflammation after?
Some redness or warmth after injection indicates lack of clean injection technique. The injection site may not have been disinfected properly before or dressed properly afterwards, resulting in a minor skin infection. Wash and clean the area well every day. The inflammation should go down after a few days.
In the future, clean the area well before injection, then dress the area with a clean bandage afterwards. Before injection, do not touch the needle with anything to prevent contamination.
Painful bump or discoloration after?
A small painful bump or discoloration a day or two after injection is likely a bruise. It is normal to bruise from an injection. It should take around 2-3 weeks to heal, over which the color may change. Avoid injecting near that area again and put a cold compress over that area.
In the future, use a cold pack and put pressure on the area right after an injection for 30-60 seconds to reduce the chance of bruising.
Small bump that still won’t go away?
Sometimes if you inject into an area frequently enough, small bumps can form especially in subcutaneous fat. These bumps are the remnants of small bruises that haven’t fully reabsorbed yet. Give those areas a rest for a few months to allow your body to reabsorb these small leftover bruises.
When should I inject?
Choose a time that is convenient for you to do at the same time of day. You may want to avoid doing it right before exercising vigorously as it may make your muscles more sore.
Why are the injections painful?
The concentration of the injection is quite high due to the need to pack so many components into a small volume. Additionally, although all injectables are formulated for the least amount of possible irritation on injection, some substances are more irritating than others.
Will it interfere with meds?
No. All the vitamins, minerals, and amino acids in the injection are formulated to avoid interfering with any medication you may be taking.