Injection Types & Sites

Medically reviewed by Carmen Pope, BPharm. Last updated on April 4, 2021.

An injection is a way of administering a liquid to a person using a needle and syringe. It’s also sometimes also called a ‘shot’ or ‘jab’. Injections are used to give a wide variety of different medications, such as insulin, vaccines and Botox (onabotulinumtoxinA), but not all injections are the same.

Read on to learn more about the four most common types of injection and where on the body they should be given. Plus find out about the basic steps for administering injections at home and tips to overcome your injection fears.

What are the different types of injections?

When ‘type’ of injection is mentioned, ‘type’ usually refers to the body tissue or path by which a medication is injected. The ‘type’ of injection describes its route of administration.

The four most frequently used types of injection are:

1. Intravenous (IV) injections. An IV injection is the fastest way to inject a medication and involves using a syringe to inject a medication directly into a vein. When people talk about receiving medication via IV, however, they are usually talking about an IV infusion or drip, which involves using a pump or gravity to infuse the medication into a vein, rather than a syringe. IV infusions allow a set amount of medication to be administered in a controlled manner over a period of time.
2. Intramuscular (IM) injections. IM injections are given deep into a muscle where the medication is then absorbed quickly by surrounding blood vessels.
3. Subcutaneous (SC) injections. SC injections are injected into the innermost layer of the skin called the subcutis or hypodermis, which is made up of a network of fat and collagen cells. SC injections are also known as ‘subcut’ or ‘SQ’ injections. These injections work more slowly than an IV or IM injection because the area does not have such a rich blood supply.
4. Intradermal (ID) injections. ID injections are given directly into the middle layer of the skin called the dermis. This type of injection is absorbed more slowly again than IV, IM or SC injections.

Injection type	Examples of medications injected via this route
IV injections	Certain antimicrobials, anticonvulsants, diuretics, steroids and analgesics
IM injections	Allergy medications, certain antibiotics and contraceptive hormones, other hormones such as testosterone, Botox, steroids, flu shots, Comirnaty (COVID-19 vaccine, mRNA) and other vaccines, B12 injections and certain antipsychotic drugs
SC injections	Insulin and other medications for diabetes, certain hormone medications such as testosterone, blood thinners, allergy medications, analgesics and arthritis medications
ID injections	Botox, steroids, and the tuberculosis (TB) vaccine. Also used for allergy testing

Some medications can be injected in more than one way. EpiPens (epinephrine) used to treat severe allergic reactions can be given via IM or SC injection, for example. Epogen (epoetin alfa) on the other hand, which is used to treat anemia, can be given by IV or SC injection. Depending on the condition you are treating, Botox may be administered as an IM, ID or intradetrusor injection.

Other types of injections include:

• Intra-articular injections - into a joint
• Peri-articular injections - into the soft tissue close to a joint
• Intraosseous injections - into the bone marrow
• Intradetrusor injections - into the muscle in the wall of the bladder
• Intraocular (intravitreal) injection - into the jelly-like fluid in the eye
• Intraperitoneal injections - given within the abdominal cavity
• Intracardiac injections - into the muscle or ventricles of the heart
• Intracavernous injections - into the base of the penis

Where is the best place to get an injection?

The best site on your body to receive an injection depends on factors such as the medication being given, what you are treating, how quickly or slowly the medication needs to work, and the type of injection you are receiving. The best type of injection for you may also be influenced by your weight, age, cost, the frequency of administration and other factors.

Where can intravenous injections be administered?

An IV injection is usually given by a healthcare professional. A small plastic tube called a catheter is typically inserted into the vein for an IV injection to be administered through, especially when more than one injection is required. IV catheters are best placed where they are easy to access and the blood flow is good.

An IV catheter is most commonly placed into a vein in the:

• Forearm
• Back of the hand
• Antecubital fossa - the depression on the inside of the elbow joint
• Ankle, close to the foot - for small patients such as babies and neonates

When selecting a site to place an IV catheter it’s important to avoid infected areas of skin and placing a catheter in a flexible joint where it may bend. Injured or sore areas, and stiff or very thin veins should also be avoided.

Where can intramuscular injections be administered?

Usually an IM injection, such as a vaccine, will be given by a healthcare professional. IM injections need to be injected into a muscle. It is recommended that an IM injection is given into a muscle in your:

• Thigh - vastus lateralis muscle between the hip and knee
• Bottom - Ventrogluteal muscle just below the hip on the side of the body
• Upper arm - deltoid muscle between the top of the shoulder and the arm pit

The best site for your IM injection may vary depending on the drug you are receiving. Some IM injections need to be administered into a larger muscle than the deltoid for example. When selecting an injection site for an IM injection it’s important to pick one that is:

• A safe distance from the surrounding nerves, bones and large blood vessels
• Large enough for the amount of medication
• Not the site of an injury, abscess, or dying skin
• Not a muscle that is emaciated or atrophied

Some people may need to administer an IM injection at home.

Where can subcutaneous injections be administered?

If you’re prescribed an injection that you have to administer yourself at home then it’s likely it’ll be a SC injection. This type of injection is used to administer medications like insulin for diabetes, hormone injections for fertility treatment and blood thinning agents to prevent blood clots.

SC injections need to be injected into an area on the body with subcutaneous fat. It is recommended that you inject a SC injection into:

• The lower abdomen (belly or stomach area), except for the 2 inches (5cm) area around the navel (belly button)
• The front or outer sides of the thighs
• The upper area of the buttock
• The upper outer area of the arms (if being administered by someone else)

When selecting an injection site take care to avoid areas where the skin is sunken or lumpy, or areas where you might inject into a muscle rather than subcutaneous tissue. Also avoid sites where the skin is injured or damaged.

Where can intradermal injections be administered?

ID injections are commonly used for allergy and TB testing. The most common sites for an ID injection are:

• The inside or ventral aspect of the forearm
• Upper back, under the shoulder blade

When administering an ID injection for allergy testing it is best to avoid areas of the body with moles, scars, rashes or a lot of hair as they can make it difficult to interpret the results of testing. Skin lesions should also be avoided except when an ID injection is being administered to help treat them, such as in the case of steroid injections for psoriasis plaques.

Rotate your injection sites - the best spot is not always the same spot

If you are receiving SC and IM injections regularly it’s recommended to rotate the site of your injections. Injecting in the same spot each time can cause the skin in that area to become lumpy or sunken.

It helps to have a plan and keep a record of your injection sites. You may find it useful to use a calendar and/or mark injection sites on a picture of a body to help you remember where you’ve recently injected.

Another tip is to select one area of the body and work your way around that area administering the injections with a 1-2 inch (2.5-5cm) gap between injection sites. Once all the sites in that area have been used, move onto another area.

5 steps to follow when giving injections at home

Some people are prescribed injectable medications that they need to administer regularly at home. Often injections given at home are SC injections, but sometimes IM injections also need to be given at home.

Always read the instructions for use that come with your medication and follow your doctor’s advice. The instructions for use set out the specific steps you need to follow to prepare and administer your medication. Different injections will have their own storage, preparation and use instructions, so it’s important to follow the instructions for the specific medication you have.

Here are 5 steps to follow when giving injections at home:

1. Wash your hands with soap and water, then dry them with a clean towel.
2. Gather all the supplies you need including the medication, an alcohol wipe, gauze, a plaster, sharps container and gloves for example.
3. Set out your supplies on a clean flat surface and get comfortable.
4. Prepare and administer your injection following the instructions for use.
5. Tidy up your supplies, including disposing of needles/syringes using your sharps container and storing your medication away as directed.

Tips to help with needle phobia

A fear of needles or injections is very common, affecting about 1 in 10 people. It can cause your heart to race, your stomach to churn, and your blood pressure to increase then rapidly drop. It can make you faint or simply feel faint. A fear of injections may cause embarrassment, but it’s nothing to be ashamed of.

Here are some tips to help when you have a fear of needles:

• Book appointments for injections in the morning, so you don’t spend all day worrying about it.
• Try relaxation techniques such as mindfulness or breathing exercises to help you relax before your injection.
• Try the Applied Tension Technique to help increase your blood pressure. Practise this technique three times a day in the week leading up to your injection. Sit in a comfortable position and:
• Tense the muscles in your legs, arms and upper body for 10-15 seconds or until your face starts to feel warm.
• Release the tension in your muscles.
• After 20-30 seconds tense your muscles again until you feel the warmth rising in your face again.
• Repeat this process five times. If you develop a headache afterwards, take care not to tense the muscles in your head and neck. Check with your doctor first to see if this technique is suitable for you.
• Ask a family member or friend for support.
• Make sure to tell the person giving your injection that you have a fear of needles or injections so that they can talk to you about your concerns and help to make you feel comfortable.
• Remember that injections only tend to hurt a little.
• Don’t look at the injection. Try distracting yourself instead by talking to someone or looking at your phone.
• Remind yourself of the importance of receiving the medication. It may help to prevent you or your loved ones from getting sick or help to treat a condition you already have.
• If a needle phobia continues to prevent you from receiving the injections you need, talk to your doctor about how to overcome your phobia.

See also

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• How to Safely Dispose of Your Old Medications
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• What are the risks vs. benefits of medications?
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• What is the placebo effect?

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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