Subcutaneous (SubQ) Injections

The medicine ordered for you or your child is given underneath the skin and into the subcutaneous (fatty) tissue. This medicine is given through an injection (needle).

Patient Instructions:

• Let the medicine reach room temperature. This decreases bruising and pain when giving the medicine.

• You can apply an ice pack to the site for a few minutes to numb the area. Place the ice pack over a layer of clothing and not directly on the skin. Your health care provider may order a numbing medicine.

• If you are giving the injection to your child:

  • Prepare the injection before approaching your child.

  • You may need to get someone to hold your child while you give the injection.

  • Approach your child in a calm, but firm manner.

  • If your child is old enough to understand, explain why they need the injection. You may need to explain this every time you give the injection.

  • Distract your child with a pacifier, toy, movie, book, squeezing a hand or an object, or any way that may be helpful.

  • Explain to your child that it is okay to cry, but they must be still.

  • Do not expect your child to adjust to receiving the injection.

  • Comfort and praise your child after you give the injection.

Gather Supplies

• Ice pack (if you want to numb the area) or numbing medicine (if ordered)

• Safe, clean work area to prepare the injection

• Alcohol swabs

• Cotton balls or gauze

• Bandage (if you or your child wants one)

• Hard plastic container for disposal of used syringes and needles

• Wear gloves when giving chemotherapy. Wash your hands before putting on the gloves and after removing the gloves.

• Medicine 

• Syringe and needle

• Each drug company and pharmacy may have their own way of mixing a medicine. Even if the dose does not change, the amount you need to draw up into the syringe may change. It depends on the way it was mixed. Each time you fill or refill a prescription, have the pharmacist show you exactly how much medicine to draw up into the syringe. 

• Caution: Keep medicine, syringes, and supplies out of the reach of children. 

Prepare the Injection

1. Wash and dry your hands or use hand sanitizer.

2. Read the label on the bottle each time you prepare the medicine. Check the label for

   • Name of the person receiving the medicine

   • Name of the medicine

   • Dose

   • Amount of medicine in the syringe (volume)

   • Expiration date

   • Storage instructions  

If you are using a vial (bottle):

1. Remove the plastic cap on the medicine vial.

2. Scrub the top of the medicine vial with alcohol and let dry.  

3. Attach the needle to the syringe. Do not touch the needle. Keep it sterile (germ-free).  

4. Take off the needle cap or needle guard. Pull back the plunger on the syringe until it reaches the correct line. Pull back the same amount of air as the amount of medicine you need.

5. Insert the needle into the rubber top on the medicine vial. Push down on the plunger to push the air into the vial. Keep the needle in the vial.

6. Turn the vial with the attached needle and syringe so the bottle is on the top and the syringe is on the bottom.

7. Make sure that the tip of the needle is below the level of the liquid in the bottle. Pull back slowly on the plunger until you are a little bit past the line that marks the dose. Keep the tip of the needle in the medicine.

8. Tap the syringe to send any air bubbles to the top. Push on the plunger to push any air bubbles out of the syringe.

9. Check that the right amount of medicine is in the syringe.  

10. Turn the vial so it is on the bottom and take the needle out of the bottle.  

11. Recap the needle and set it aside.  

If you are using a prefilled syringe:

Prefilled syringes may come with a needle or a cap on the end of the syringe.

If you need to attach a needle to the syringe:  

1. Peel open the needle. Do not touch the uncovered end.  

2. Twist the cap off the syringe.  

3. Do not touch the tip of the syringe.  

4. Twist the needle onto the end of the syringe.  

5. Push up on the plunger until a drop of medicine appears at the needle tip.  

6. Check that the right amount of medicine is in the syringe. If you are not using the full amount of medicine in the syringe, carefully squirt out the extra medicine until the plunger lines up with the correct amount for the dose. 

Give the Injection

1. Choose an injection site: back of upper arm, thigh (front, side or back), abdomen (belly) or buttock.  Choose a different site each time you give the medicine.  This will help the medicine work better. When choosing an injection site avoid areas with bruising, redness or swelling.

2. Wipe the injection site with alcohol and let dry.

3. Pinch skin at the site to bring the fatty tissue away from the muscle.

4. Hold the syringe like a pencil. Insert the needle through the skin at a 45° or 90° angle until the entire needle is in the skin. The angle depends on how much fat is at the site. You will be told which angle to use.

5. Inject the medicine slowly by pushing the plunger all the way down into the syringe. Inject at a speed of about 10 seconds for each ml of medicine or 1 second per 10 units of medicine when using an insulin syringe.

6. Release the pinch of skin.

7. Pull the needle out of the skin. Apply pressure to the site with a gauze pad or a cotton ball.  Do not rub.

8. Cover site with a bandage if you wish.

9. Do not recap the needle. Dispose of the syringe and needle in a hard container (needle box or laundry detergent bottle). You will need to find out what services are available in your area to dispose of the container.

Your healthcare provider, pharmacist, local health department, township office and state Department of Environmental Protection can give you more information about safe needle disposal. www.safeneedledisposal.org

Helpful Tips

• Make sure you have enough medicine and supplies.

• Plan ahead for weekends and vacations.

• Renew prescriptions before your supply runs out.

• When you renew the prescription, always read the label.

Reviewed October 2024 by Linda Kocent MSN, RN, NEA-BC