Subcutaneous injection technique — evidence-based protocol

The lump from injecting in the same spot is called lipohypertrophy (or possibly lipodystrophy) and it can actually affect absorption of the medication! You might have been getting inconsistent dosing because of it. The good news is it usually resolves if you avoid that area for a few months.

My injection rotation system:

• I divide my abdomen into 4 quadrants (upper left, upper right, lower left, lower right)
• I rotate through them each week: week 1 upper left, week 2 upper right, etc.
• Within each quadrant, I vary the exact spot by an inch or so
• I stay at least 2 inches away from my navel

This way I don't hit the same spot more than once a month.

Great thread. Injection technique is one of those things that seems simple but actually matters a lot for consistent drug delivery. A few clinical pearls:

Needle retention time: The Wegovy prescribing information recommends keeping the needle inserted for at least 6 seconds after the dose counter shows "0." This ensures the full dose is delivered. With higher doses (1.7mg, 2.4mg), some pharmacists recommend 10 seconds because the volume is larger.

Injection sites: Approved sites are abdomen (>2 inches from navel), front of thigh, and upper arm (outer area). Bioavailability is approximately 89% regardless of site, but absorption rate can vary slightly.[1]

Temperature: Let the pen sit at room temperature for 30 minutes before injection. Cold medication can cause more injection site pain and may absorb slightly differently.

No rubbing: Correct — don't rub or massage the injection site. This can cause bruising and may increase the rate of absorption, potentially worsening side effects.

Pinch technique: For most patients, pinch a 1-2 inch fold of skin and inject at 90 degrees. For very lean patients, a 45-degree angle may be more appropriate to avoid intramuscular injection.

the cold pen thing — this was me for my first two months. I was literally injecting ice cold medication and wondering why it burned 😭 night and day difference once I started letting it warm up

Wait you're not supposed to rub the site?? I've been doing that literally every single time because I thought it helped distribute the medication. Oops 🤦‍♂️