Ask the Pharmacist: What to Expect with At-Home Injectable Medications

February 28, 2024

By: Rachel Noonan, PharmD

If you’re new to at-home injectable medications, you undoubtedly have some questions and concerns. Belmar Pharmacist, Rachel Noonan, Pharm D, answers some of the most frequently asked questions about administering common types of injectable medications. Additionally, you’ll find links to Belmar’s detailed instruction guides for best practices.  

Q: What type of sterile injectable medications does Belmar Pharmacy offer? 

A: Our 503A pharmacies compound sterile injectables to be given subcutaneously (SC), intramuscularly (IM), or via intracavernosal injection (ICI). SC injections are administered under the skin; IM injections are given into the muscle; and ICI is injected along the shaft of the penis. We do not compound medications to be given intravenously.  

The great part of having sterile injectable options on our formulary is that it allows us to offer medications that may not be optimally absorbed through other routes. For example, some medications, when given orally, are heavily broken down by digestive enzymes in the liver. Inadequate absorption can prevent drugs from doing what they are designed to do.  

Q: Injecting my medication is new for me. How do I know where to start? 

A: The label on your specific prescription will explain how to properly administer your injection. We provide detailed instruction sheets with step-by-step guidance to help you with appropriate technique: 

IM Instruction Guide  

SC Instruction Guide 

ICI Instruction Guide 

If you have any questions after reviewing these instructions, reach out to the pharmacy directly, or to your healthcare provider.  

Q: After using my medication, what can I expect at the injection site? 

A: Injection site reactions are a potential side effect with all liquid injections. They are possible with any injection method and are typically short-lived and mild in nature. Keep in mind that whenever you inject a medication into the muscle or skin, you are breaking the skin barrier and introducing an outside substance into your body.  

Each medication is different, and all have varying degrees of site reaction rates. Common injection site reactions include bruising, bleeding, swelling, redness, and pain. These reactions generally last no more than a day or two.  

As an example, when testosterone cypionate is given under the skin, here are the most common responses, and the percentage of patients who typically experience these results:  

  • Bruising (4-7%) 
  • Bleeding (3-6%) 
  • Pain (5%) 
  • Redness (3%) 

Q: What type of injection site reactions are concerning? 

A:  Although rare, it’s possible to experience more severe reactions after injecting medication, such as: 

  • Fever 
  • Blistering at the injection site 
  • Severe pain or swelling 
  • Skin rash or hives 
  • Vomiting, headache, dizziness 
  • Muscle or body aches 
  • Difficulty breathing 

Be familiar with signs of an allergic reaction, such as full body hives. Signs of an infection may also include skin discoloration that spreads beyond the injection site; oozing discharge at the site; or skin that is hot and tender to the touch. 

If symptoms persist or you’re concerned, it’s a good idea to contact your healthcare provider.  

Q: What can I do to decrease the risk of injection site reactions? 

A: Decreasing risk of injection site reactions begins with carefully preparing the site. Proper aseptic technique involves cleaning or sterilizing the injection site with an alcohol swab prior to performing the injection. This practice helps avoid introducing germs to the site and reduces the risk of infection. Be sure to let the alcohol dry, otherwise you may feel a bit of an additional sting when the needle breaks the skin.  

Use a clean needle, EVERY TIME. Reintroducing a previously used needle into your body can increase your risk of infection. Having the right supplies is also important. Your pharmacy and doctor will help make sure you receive the correct needles and syringes to properly administer your prescription.  

Switch it up! Another key point for reducing injection site reactions is rotating sites. Injecting in the same spot repeatedly may result in irritated skin or scar tissue. Depending on the method of injection (IM or SC), there are multiple injection site options on the body. (See the detailed instruction sheets listed above.) 

Q: How painful is this process? What do I do if I’m not comfortable injecting myself?  

A: How an injection feels can depend on the medication and how it is introduced into the body. Pain is subjective, meaning every person has a different threshold and experience.  

Some patients don’t like needles and feel uneasy giving themselves injections. Many providers offer in-house consultation and administration, to reduce anxiety and discomfort.  

If it’s your first time injecting medications at home, it’s understandable that you may feel cautious or nervous about doing it correctly. Follow the instructions on your medication, and the instruction sheets above. With practice, you may feel more confident injecting your medication, so it becomes second nature.  

And as always, Belmar pharmacists are here to answer your questions.