Before the Injection

1. Some medications such as Kineret^® and Enbrel^® must be injected. These medications come with a kit and a device to inject the medication. Some patients however prefer not to use the kit but to do the injection themselves; much like an insulin injection would be done.
2. If your medication is refrigerated, remove the vials from the refrigerator 30 minutes before administration so it can reach room temperature.
3. Select a clean, dry work area.
4. Gather your supplies:
   – Medication
   – Sterile water
   – Sterile disposable needles and syringes
   – Alcohol pads or cotton balls and bottle of rubbing alcohol
   – Puncture-proof disposal container*
   – Bandaids
5. Wash your hands well before preparing your medication.

*HINT The container can be a coffee can or leak-proof, closable milk jug. Find out the proper way to dispose of biological waste in your area.

Preparing the Injection

Your doctor and/or clinic nurse will instruct you on preparing your particular dose of medication.

Giving Yourself the Injection

Select your injection site. This must be an area that has a layer of fat between the skin and the muscle. This is called subcutaneous. The following parts of your body have subcutaneous layers:

• outer surface of the upper arm
• top of thighs
• buttocks
• abdomen, except the navel or waistline

1. If you are very thin do not use the abdomen as an injection site.
2. Do not use the same site for injections each time.
3. Rotate your injection sites in a regular pattern. You should be at least 1 ½ inches away from the last injection site. Jot down on your calendar where you gave you last shot. This will help prevent giving the shot in the same place too soon.
4. Select a site and cleanse the area (about 2 inches) with a fresh alcohol pad, or cotton ball soaked in alcohol.
5. Wait for the site to dry.
6. Remove the needle cap.
7. Pinch a 2-inch fold of skin between your thumb and index finger.
8. Hold the syringe the way you would a pencil or dart. Insert the needle at a 45 to 90 degree angle to the pinched-up skin. The needle should be completely covered by skin. If you do this quickly, you will feel very little discomfort.
9. Hold the syringe with one hand. With the other, pull back the plunger to check for blood. If you see blood in the solution in the syringe, do not inject. Withdraw the needle and start again at a new site.
10. If you do not see blood, slowly push the plunger to inject the medication. Press the plunger all the way down.
11. Remove the needle from the skin and gently hold an alcohol pad on the injection site. Do not rub.
12. If there is bleeding, apply a bandage.
13. Immediately put the syringe and needle into the disposal container*.