If a small vial and a bag of insulin syringes arrived from the pharmacy, this is the routine. It takes a few minutes, and most people find the second injection easier than the first. The printed instructions in your package and anything your clinician told you come first; where this guide differs, please go with theirs.
This guide is general
It covers any compounded medication a licensed partner pharmacy fills and ships as a vial with insulin syringes. Your dose, schedule and number of units are on the pharmacy label, so this page gives none of them.
What arrives
- A small glass vial of medication, in its carton.
- Insulin syringes, each sealed in its own wrapper, with a short, fine needle attached. One per injection.
- Alcohol swabs.
- A rigid, lidded container for used needles (a sharps container). If one is not in the box, pharmacies sell them, and a heavy plastic laundry-detergent bottle with a screw-on cap works until it arrives.
Storage
The vial lives in the refrigerator, in its carton, which keeps light off it. Please keep it from freezing; a vial that has frozen is not usable. If the package arrived warm, or you think the vial froze, it is worth calling the pharmacy on the label before using it. The label also says how long the vial is good once opened.
Before the first draw
- Please wash your hands with soap and water and dry them.
- Set out one syringe, two swabs, a tissue, the vial and the sharps container on a clean surface.
- Let the vial sit out for a few minutes. A room-temperature injection is more comfortable than a cold one, and the counter is all it needs.
Reading the syringe
An insulin syringe is marked in units along the barrel. Count the lines between two printed numbers to see what one line is worth; on many syringes it is one unit, on some it is two. The number of units for your dose is on the pharmacy label or instruction sheet, and that is the number to draw to. If it is missing or unclear, a message to your care team before the first injection is worth sending. Another person's number may not apply to your vial.
Drawing up the dose
- The first time, flip the plastic cap off the vial. Wipe the rubber stopper with a swab and let it dry.
- Uncap the syringe and draw the plunger back to your number of units, which fills it with that much air.
- Push the needle through the stopper and press the plunger in. The air makes the liquid easier to draw.
- Turn the vial and syringe upside down together, keeping the needle tip in the liquid, and pull the plunger a little past your number.
- Tap the barrel so any bubbles rise toward the needle, then press the plunger up to your number, which sends the air back into the vial.
- Pull the needle out of the vial and check that the plunger sits on your number.
Choosing a spot
- The abdomen, at least two inches from the navel.
- The upper thigh, the front or outer side.
Each injection goes in a different spot, at least an inch from the last. Alternating sides (left abdomen, right abdomen, left thigh, right thigh) is an easy pattern. Skin that is bruised, tender or irritated gets a pass that day.
The injection
- Wipe the spot with a fresh swab and let it air-dry; injecting through wet alcohol stings.
- Pinch about an inch of skin and the fat beneath it between your thumb and first finger. Skin and fat, not muscle.
- Hold the syringe like a pencil and put the needle in with one smooth motion, straight in at 90 degrees. If the fold you can pinch is thin, 45 degrees keeps the needle in the fat layer. Your clinician may have shown you one or the other.
- Press the plunger slowly and steadily until it is all the way in.
- Pull the needle straight out, let go of the pinch, and press lightly with a tissue if a drop of blood appears. Rubbing is not needed.
Afterward
The whole syringe goes into the sharps container right away, without putting the cap back on; recapping is how needle sticks happen. When the container is about three-quarters full, close the lid. Where it goes from there depends on local rules: many pharmacies and household hazardous-waste programs take sealed sharps containers. The pharmacy on your label can tell you what works where you live.
What is normal
A small bump, a little redness, an itch or mild soreness at the spot, fading within a day or two. A tiny drop of blood or a small bruise now and then. None of that needs a call.
When to reach out
Message your care team from the app or the portal if a spot stays red, warm, swollen or painful for more than a couple of days, or if you are unsure about your number of units.
Hives, swelling of the face, lips or tongue, or trouble breathing can be signs of an allergic reaction. Those need emergency care right away: call 911 or go to the nearest emergency room, and let your care team know afterward.
Sources
- MedlinePlus, U.S. National Library of Medicine. Subcutaneous (SQ) injections. Reviewed October 19, 2025.
