This is usually given as an intramuscular injection, every 2-3 months.
Alternatives to an intramuscular injection are:
Oral Vitamin B12 at a dose of at least 1000mcg per day.
- Available as tablets or a spray. They can be bought over the counter and available at most health food stores and pharmacies.
- Oral Vitamin B12 is not recommended if:
- If you have a bowel condition such as inflammatory bowel disease, Coeliac disease, small bowel overgrowth, bile acid malabsorption and short bowel (you will require injections)
- You require an initial loading of B12 (soon after diagnosis)
It is important to monitor your symptoms if you change to oral B12. If symptoms return, then the oral/sublingual dose can be increased to 2000mcg or you may need to consider starting back on injections.
Subcutaneous (SC) injection
This is off-licence but still effective. It is considered an easier method of administration. It is how insulin and blood thinning medication are usually self-administered.
Equipment needed to self-inject
- Prescribed medicine
- 1 syringe (2 ml)
- 2 needles (1 for drawing up the drug and 1 for administration – you can use the same size needle for both)
- For an IM injection; the needle gauge should be 19-25. The needle length is 1- 1 ½ inches (up to 3 inches for larger adults)
- For a SC injection; the needle gauge should be 25-27. The needle length should be ¼ to 5/8 of an inch
- Sharps box with a yellow lid
These can be purchased online without a prescription. This is normally the most cost-effective way; Amazon have a good stock. If you have any problems purchasing equipment please contact the health centre.
There is no need to purchase alcohol wipes. PHE (2013) advised that if you are physically clean and in good general health then swabbing prior to injecting is not required.
Intramuscular injections: site and needle angle
The easiest site when self-administering an IM injection is the middle third of the vastus lateralis muscle of the thigh.
The vastus lateralis site is in the lateral middle third of the thigh between the greater trochanter and the knee. When injecting, lift the vastus lateralis muscle away from the bone.
Other options include the deltoid muscle of the upper arm and the dorsogluteal site on the bottom. This maybe useful if you have a carer or a family member willing to administer your injection.
The thickest part of the deltoid muscle is 2.5-5cm (1-3 finger breadths) below the lower edge of acromion process of the scapula over the midaxillary line.
The dorsogluteal site is above an imaginary line between the greater trochanter and the posterior superior iliac crest. The injection is administered laterally and superior to this imaginary line.
The angle of the needle with IM injections should be 90 degrees.
Subcutaneous injections: site and needle angle
The easiest sites for self-administration are the abdomen and upper thigh. If injecting into the abdomen, avoid injecting within 2 inches around the umbilicus.
How to give an injection
- Wash and dry hands to reduce the risk of infection.
- Assemble the syringe and needle and withdraw the required amount of drug from the ampoule, with B12 and Sustanon this is normally all the drug in the ampoule. Some medicines are available in pre-filled syringes and manufacturer’s instructions should be followed (MMR).
- Disperse air bubbles from the syringe.
- Change the needle. Doing so will ensure that the needle used for the injection is sharp, thereby reducing pain.
- Insert the needle quickly into your preferred site and slowly and steadily inject the medicine. There is no need to pull back on the syringe to check for blood.
- Dispose of the used needle in a sharps container according to local policy.
Please contact the health centre on 01273 249049 if you have any concerns following your injection.