If you have to inject at a different time of day than usual, that is a much smaller perturbation than it feels for a weekly compound with a week-long half-life.
Angle of injection and whether 90 degrees is always right — the long version posts 31–56
This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.
Leak-back after withdrawal: a small amount of liquid on the skin after withdrawal is ordinary. Whether you lost a "meaningful" dose depends on concentration and your target dose, but some leak-back is universal and does not need to be treated as an error.
Injecting into an area that has become firm: lipohypertrophy — thickened fatty tissue from repeated injection in one area — changes local tissue absorption. Avoid injecting into areas that are noticeably firm or lumpy and allow those areas to recover for at least a few months.
Written in the hope of being told what I have missed.
Everything in post #31 holds. The case it does not cover is the one I have.
Distinguishing three things in the Angle of injection discussion that keep getting used interchangeably: the observation, the proposed mechanism, and the recommendation that gets attached to both.
Injection discomfort: comes from needle gauge (finer = less discomfort), volume (smaller = less discomfort), temperature (room temperature or warmed is less uncomfortable than cold), and technique (smooth, purposeful injection is less uncomfortable than hesitant). All four are under your control.
A weak preference rather than a position.
I read post #34 twice before replying, because I had assumed the opposite.
Angle of injection is worth one more sentence than it usually gets, and the sentence is the one about how the number was arrived at.
Post #36 is the version of this I will quote in future. One addition.
Cold solution and stinging: warming the vial in your hands for a minute before injection reduces the stinging sensation substantially. This is the simplest thing to try if injections are uncomfortable.
Flagging that the sources on this are thinner than the confidence in the thread suggests.
Where I part company with post #38, and it is a narrow parting.
Injecting into an area that has become firm: lipohypertrophy — thickened fatty tissue from repeated injection in one area — changes local tissue absorption. Avoid injecting into areas that are noticeably firm or lumpy and allow those areas to recover for at least a few months.
Genuinely open to being wrong about this one.
Quietly grateful for the plain phrasing. Not every thread gets that.
Confirming post #39 from a second method, which matters more than confirming it from a second person.
If you have to inject at a different time of day than usual, that is a much smaller perturbation than it feels for a weekly compound with a week-long half-life.
Somebody will have a better source than mine, and I hope they post it.
Subcutaneous injection into abdominal tissue, thigh or upper arm is what the licensed labelling in this class describes, and the published comparisons found the differences in exposure between those sites small.
Needle length matters less than angle for subcutaneous delivery in most people. A short needle at ninety degrees and a longer one at forty-five put the material in roughly the same place.
Post #43 is right about the mechanism and I think understates the practical bit.
Drawing up with one needle and injecting with another: a reasonable practice if you have extra needles. Fresh needle for injection reduces tissue drag and can decrease discomfort. Not necessary, but not harmful either.
Bleeding at the injection site: normal and usually minimal. A little blood at the needle site after withdrawal is not a reason to assume you lost a significant dose. The needle passed through tissue and there is a small amount of bleeding in the tract.
It is a small point and it changes the answer, which is an awkward combination.
The version of Angle of injection that circulates here is a simplification of a simplification. It is not wrong, but it has lost the conditions under which it holds, and those conditions are where the interesting cases live.
Alcohol swabbing and letting the site dry is the whole of the preparation for a subcutaneous injection into intact skin. Injecting before it dries is what stings.
Posting it because the silence on this was starting to look like agreement.
Taking post #50 at face value and following it one step further.
I would be cautious about generalising from the Angle of injection example above. It is a good example. It is one example.
A genuinely late dose: the labelling generally says that if the next dose is more than a couple of days away, take it as soon as you notice. If the next dose is close, skip it and resume the schedule. The reasoning follows from the long half-life; you are perturbing a slowly moving average.
Happy to be corrected if someone holds better data than mine.
Pinch or no pinch: the decision depends on needle length and on your own anatomy. A longer needle (8 mm and up) reaches subcutaneous tissue easily without a pinch. A shorter needle (4-6 mm) is safer with a gentle pinch. The pinch size matters less than people think; the injection angle matters more.
This is the sort of thing the wiki should carry and currently does not.
Worth separating two things that post #52 runs together.
The reason Angle of injection is hard to answer is that the obvious measurement and the relevant quantity are not the same thing, and substituting one for the other is silent.
This topic was referenced in
- About the Administration categoryPractice › Administration · 9 replies
- Second pass at: Leak-back after withdrawal and whether you lost a meaningful dosePractice › Administration · 22 replies
- A genuinely late dose: what the labelling says and what people do — what changed sincePractice › Administration · 13 replies
Suggested topics
| Topic | Participants | Replies | Views | Activity |
|---|---|---|---|---|
|
Rotating between abdomen, thigh and upper arm: absorption differences
On the subject in the title: Rotating between abdomen, thigh and upper arm: absorption differences Working notes rather than a conclusion. Asking about rotating between abdomen directly, because I have read…
|
2 | 3.5k | 5mo | |
|
Pinch or no pinch, and how needle length changes the answer — what changed since
Posting this under the heading it deserves: Pinch or no pinch, and how needle length changes the answer — what changed since Everything below is what sits behind that. What changes if the standard account of…
|
+58 | 62 | 16k | 1d |
|
A site rotation scheme that is easy enough to actually follow
On the subject in the title: A site rotation scheme that is easy enough to actually follow Working notes rather than a conclusion. Two things I would like separated before anyone answers on site rotation…
|
+112 | 125 | 5.8k | 21h |
|
Bleeding at the injection site: normal, and what to do about it
Bleeding at the injection site: normal, and what to do about it — setting out what I have, and where I think it stops being reliable. Something changed and I would like to know whether it should have. Same…
|
3 | 59k | 8mo | |
|
Injecting into an area that has become firm: why not to — does this still hold?
Asking directly, because I could not find a straight answer: Injecting into an area that has become firm: why not to — does this still hold? Something changed and I would like to know whether it should have.…
|
2 | 49k | 9mo |
Related topics — sharing the tags injection site reaction, needle gauge & length, injection site rotation
| Topic | Participants | Replies | Views | Activity |
|---|---|---|---|---|
|
Completing a dose with a second syringe, and the dead-volume arithmetic
Posting this under the heading it deserves: Completing a dose with a second syringe, and the dead-volume arithmetic Everything below is what sits behind that. I have read the maintained page on this and I…
|
+65 | 76 | 7.4k | 1d |
|
"Should I double up?" — answered once, at length, calmly
"Should I double up?" — answered once, at length, calmly — setting out what I have, and where I think it stops being reliable. A practical question that I suspect has a boring answer, which is why I could not…
|
+24 | 28 | 13k | 9mo |
|
Revisiting: Drawing up with one needle and injecting with another
Revisiting: Drawing up with one needle and injecting with another Writing it up because I had to work it out twice and would rather nobody else did. A practical question that I suspect has a boring answer,…
|
+76 | 83 | 1.1k | 4mo |
|
Leak-back after withdrawal and whether you lost a meaningful dose
Posting this under the heading it deserves: Leak-back after withdrawal and whether you lost a meaningful dose Everything below is what sits behind that. I have read the maintained page on this and I still…
|
2 | 3k | 3h | |
|
Gauge and length selection for subcutaneous injection
Gauge and length selection for subcutaneous injection Writing it up because I had to work it out twice and would rather nobody else did. A follow-up question about gauge and length selection that I did not…
|
+50 | 55 | 1.3k | 8mo |