Giving Yourself an Injection Under the Skin With Blood Thinning Medication in a Prefilled Syringe

This information describes how to prepare and give yourself an injection (shot) under your skin with blood thinning medication in a prefilled syringe.

You will need to give yourself injections of blood thinning medication. You will get prefilled syringes with the medications already in them. You will use a small, short needle to give the medication into the fat right under your skin.

Your prefilled syringe may come with a needle already attached or you may need to attach it yourself. If your syringe doesn’t come with the needle attached, follow the instructions for attaching it in the “Preparing and Giving Yourself the Injection” section

You will practice preparing and giving yourself an injection with your nurse. When you’re at home, use this resource the first few times you give yourself the injections.

Preparing and Giving Yourself the Injection

  1. Prepare a clean area to set up your supplies, such as a kitchen table. Don’t use the bathroom as a work area.
  2. Gather your supplies:
    • Pre-filled syringe and 27 gauge, 1/2-inch needle or
    • Pre-filled syringe with the needle attached
    • Alcohol pads
    • Disposable sharps container, such as an empty plastic bleach or detergent bottle with a cap, labeled “Home Sharps-Not for Recycling”.
    • 2 x 2 gauze pad or cotton ball
  3. Clean your hands:
    • If you’re washing your hands with soap and water, wet your hands, apply soap, rub them together thoroughly for 15 seconds, then rinse. Dry your hands with a disposable towel, and use that same towel to turn off the faucet.
    • If you’re using an alcohol-based hand sanitizer, be sure to cover your hands with it, rubbing them together until they’re dry.
  4. Tear off any 3 edges on the sealed alcohol wipe. Hold the packet at the edge that you didn’t tear. Carefully open the packet to expose the alcohol wipe, but don’t take it out. Set the open packet on your work area. You will use this alcohol wipe to clean your skin just before you inject the medication.
  5. Check to see if the syringe has a built-in needle. If it doesn’t, follow the steps below to put a needle on the syringe.
    • Remove the black cap on the tip of the syringe. Don’t let anything, including your fingers, touch the tip once the cap is off.
    • Remove the needle from its package. Do not let anything, including your fingers, touch the needle. If anything touches the needle, you must throw it away in the sharps container.
    • Twist the needle onto the base of the syringe using a clockwise (to the right) motion.
  6. Check to make sure that the syringe has the correct amount of medication. Don’t worry about tiny amounts of air in the syringe.
  7. Choose an injection site from the areas shown in Figure 1. Keep track of which site you used last and give the injection at a different site each time. Don’t use an area that’s less than 2 inches (about 5 centimeters) from a scar.
    Figure 1. Choosing an injection site
  8. Remove or fold back any clothing that covers the injection site.
  9. Use the alcohol wipe to clean the area where you’re going to give the injection. Let it air dry. Don’t fan or blow on the area.
  10. Pick up the syringe with your dominant hand (the hand you write with).Using your other hand, take the protective cap off the needle. Don’t let anything, including your fingers, touch the needle. If anything touches the needle, you must throw it away in the sharps container. See the instructions in the section “What to Do if Anything Touches the Needle.”
  11. Point the needle up.
  12. Using your nondominant hand (the hand you don’t write with), pinch a 1 to 2 inch (2.5 to 5 centimeter) fold of skin between your thumb and first finger. You should still have the syringe in your other hand.
  13. Hold the syringe like you would hold a pencil or dart. Insert the needle into your skin in one quick motion at a 90 degree (straight up and down) angle (see Figures 2 and 3). ​
    Figure 2. Giving the injection
    Figure 3. Inserting the needle
  14. Push the plunger on the syringe to inject the medication.
  15. Take the needle out of your skin at the same angle you put it in. Don’t put the protective cap back on the needle. Put the syringe and needle into the sharps container to throw away.
  16. Put firm pressure on the injection site using a sterile gauze pad or cotton ball. After the bleeding has stopped, put a dry gauze or bandage on the site. Don’t rub the area or press very hard. Injecting blood thinning medication can cause a lot of bruising.
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What to Do if Anything Touches the Needle

If you are using a syringe with a built-in needle, throw it into your sharps container. Start the process again with a new prefilled syringe.

  • If you need to throw away a syringe with a built-in needle, you will need to replace it. Call your doctor for a prescription.

If the needle and syringe were not attached, change the needle using the following steps:

Figure 4. Twisting the hub
  1. Open the package with the fresh needle, but don’t take out the capped needle. Put the open package on your work area.
  2. Remove the old needle from the syringe by twisting the base of the needle counter-clockwise (to the left, see Figure 4). If you have trouble twisting it, carefully recap the needle. Then twist it again.
  3. After you remove the needle, place it in your sharps container. Don’t let anything touch the base of the syringe.
  4. Take the new capped needle out of the package. Attach it to the syringe by twisting it clockwise (to the right).
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How to Store and Dispose of Your Home Medical Sharps

Storing Your Medical Sharps

  • Use an empty plastic container with a screw-on cap, such as a laundry detergent bottle.
    • Pick a container that’s strong enough that needles can’t poke through the sides.
    • Pick a container that isn’t breakable.
    • Don’t store your sharps in glass bottles, soda bottles, milk jugs, aluminum cans, coffee cans, or paper or plastic bags.
  • Clearly label the container “Home Sharps – Not for Recycling”. Keep it away from children and pets.
  • Put the sharps in the container point-first as soon as you use them.
  • Don’t overfill the container. When it’s more than half full, stop using it. Wrap the cap with strong tape to create a more secure seal and prevent leakage.
  • Keep the container separate from trash that will be recycled.
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