Subcutaneous (SQ) injections

The best areas on your body to give yourself a SQ injection are:

• Upper arms. At least 3 inches (7.5 centimeters) below your shoulder and 3 inches (7.5 centimeters) above your elbow, on the side or back.
• Outer side of upper thighs.
• Belly area. Below your ribs and above your hip bones, at least 2 inches (5 centimeters) away from your belly button.

Your injection site should be healthy, meaning there should be no redness, swelling, scarring, bruising, or other damage to your skin or the tissue below your skin.

Change your injection site from one injection to the next, at least 1 inch apart. This will keep your skin healthy and help your body absorb the medicine well.

You will need a syringe that has a SQ needle attached to it. These needles are very short and thin.

• Do not use the same needle and syringe more than once.
• If the wrapping or cap on the end of the syringe is broken or missing, throw it away in your sharps container. Use a new needle and syringe.

You may get syringes from the pharmacy that are pre-filled with the correct dose of your medicine. Or you may need to fill your syringe with the correct dose from the medicine vial. Either way, check the medicine label to make sure you are taking the correct medicine and the correct dose. Also check the date on the label to make sure the medicine is not outdated.

In addition to a syringe with the medicine, you will need:

• 1 alcohol pad
• 2 or more clean gauze pads
• A sharps container

The following steps should be followed:

• To help prevent infection, wash your hands with soap and running water for at least 1 minute. Thoroughly wash between your fingers and the backs, palms, and fingers of both hands.
• Dry your hands with a clean paper towel.
• Clean your skin at the injection site with an alcohol pad. Start at the point you plan to inject and wipe in a circular motion away from the starting point.
• Let your skin air dry, or wipe it dry with a clean gauze pad.

The following steps should be followed when preparing your syringe:

• Hold the syringe like a pencil in the hand you write with, pointing the needle end up.
• Take the cover off the needle.
• Tap the syringe with your finger to move air bubbles to the top.
• Carefully push the plunger up until the dark line of the plunger is even with the line of your correct dose.

If you are filling your syringe with medicine, you will need to learn the proper technique for filling a syringe with medicine.

The following steps should be followed when injecting the medicine:

• With the hand that is not holding the syringe, pinch an inch (2.5 centimeters) of skin and fatty tissue (not the muscle) between your fingers.
• Quickly insert the needle all the way into the pinched skin at a 90-degree angle (45-degree angle if there is not much fatty tissue).
• Once the needle is all the way in, release the skin.
• Inject all the medicine by pushing in the plunger.
• Once the medicine is all in, pull out the needle quickly.
• Put the needle in your sharps container.
• Press clean gauze on the site and hold pressure for a few seconds to stop any bleeding.
• Wash your hands when you are done.

SQ injections; Sub-Q injections; Diabetes subcutaneous injection; Insulin subcutaneous injection

Del Valle Rolón ME. Procedures. In: Anderson CC, Kapoor S, Mark TE, eds. Harriet Lane Handbook, The. 23rd ed. Philadelphia, PA: Elsevier; 2024:chap 4.

Valentin VL. Injections. In: Dehn R, Asprey D, eds. Essential Clinical Procedures. 4th ed. Philadelphia, PA: Elsevier; 2021:chap 13.

Updated by: Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.