You might be able to give yourself shots of your medicine at home as part of your treatment for rheumatoid arthritis.
Self-injections may be an option for you if your RA doctor (rheumatologist) prescribes a powerful type of medicine called a biologic, says Nilanjana Bose, MD, a rheumatologist with Lonestar Rheumatology in Houston. Biologics are usually for people with moderate to severe RA, she says. Several kinds of them need to be injected (or given to you as an IV at the doctor’s office) because they don’t come in pill form.
You might also have the option of giving yourself injections if your doctor prescribes certain kinds of DMARDs (disease-modifying antirheumatic drugs). These usually treat mild RA, Bose says. DMARDs are often available as pills, but some (like methotrexate) you can give yourself in the form of a shot.
If you and your doctor decide that self-injections are right for you, they’ll have a member of your RA treatment team (like a nurse) show you how to give yourself a shot. Once you feel ready to try it yourself at home, you’ll need to follow their directions exactly.
These general tips can help, too.
What Types of Self-Injections Are Available?
Depending on the drug your doctor prescribes, you might have the choice of injecting yourself with a syringe or with an auto-injector pen.
A syringe could come prefilled with your medication or empty. If you use an empty syringe, you’ll need to fill it with the correct dose of your medicine from a multiuse vial. And when you give yourself an injection, you’ll need to push down on the device’s plunger.
An auto-injector pen is a device that’s designed for people with arthritis, Bose says. So, it might be easier for you to grip and use than a syringe, especially if you have arthritis in your hands or fingers. It comes prefilled with the right dose of your RA medicine. In general, you take the cap off the pen and press a button to inject yourself.
What Should You Do Before You Give Yourself an Injection?
Let your medicine warm up. Most injectable meds for arthritis need to be stored in your refrigerator. (You shouldn’t freeze them or shake them, though.)
Before you inject yourself, take your next dose of medication out of the fridge, and give it about 20 to 30 minutes to reach room temp. This may help the shot sting less, too.
Never heat your RA medication up in the microwave or by boiling it in water.
Consider making your skin comfortably numb. You can help ease the pain of the shot by placing an ice pack on the part of your body where you plan to inject your medicine. Do this about 15 minutes before you give yourself a shot.
You could also ask your doctor to prescribe numbing cream instead.
Relax. If you’re a bit nervous about giving yourself a shot, try to do something that relaxes you, like breathing exercises or listening to mellow music.
Tense muscles can make a self-injection more painful. If you sit rather than stand, it may help your muscles chill out.
Gather some key items. Along with your medication and injection devices, you’ll want to round up a few important things before you give yourself a shot of RA medicine, like:
- An alcohol wipe (or a cotton ball and rubbing alcohol) to clean your skin
- A puncture-proof needle disposal container to safely throw away used needles, syringes, or auto-injector pens
- Bandages in case you bleed
Place these on a clean, dry surface.
How Do You Give Yourself a Shot of RA Medicine?
Follow the instructions your doctor, nurse, or pharmacist gives you. You can also use these tips:
Choose where you’ll inject yourself. You’ll give yourself the shot into a layer of fat between your skin and muscle. Doctors call that a subcutaneous injection. Some good places on your body to give yourself this type of shot are the:
- Outer surface of your upper arm
- Top of your thighs
- Butt
- Belly (not in the bellybutton or waistline, though)
Don’t give yourself a shot in the belly if you’re very thin.
Also, don’t inject the same exact part of your body each time. This could make it become sore or painful. Change to different areas in a regular pattern. Inject yourself at least 1½ inches away from the last place you gave yourself a shot. You can keep track of where you last injected yourself on a calendar.
Prepare your skin for the shot. Clean the area with a new alcohol pad or with a cotton ball soaked in rubbing alcohol. Rub in a circular motion for about 30 seconds. Then let your skin dry.
Get your injection ready. Take off the cap that covers the needle.
If you’re using an auto-injector pen, you can pinch up a bit of skin between your thumb and pointer finger to create a firm surface for the injection. You don’t have to, though.
Hold the pen at a 90-degree angle to your skin. Press the tip firmly against it. Then press and hold the button on the pen to inject the medicine.
It’s common for auto-injector pens to click twice when you use them: once when you press the button, and another when it’s done giving you your medicine. Certain pens also have a way to indicate on them that you used the medicine in it, such as a flashing light.
If you’re using a syringe, pinch 2 inches of skin between your thumb and pointer finger. With your other hand, grip the syringe the way you’d hold a pencil or dart.
Insert the needle at a 45- to 90-degree angle to your skin. Your skin should completely cover the needle. If you insert it quickly, it might not hurt much.
Keep holding the syringe. Use your other hand to pull back the plunger and check for blood in the solution in the syringe. If you see any, take out the needle and re-do the steps on a different patch of skin.
If you don’t see any blood, inject the medication by slowly pushing the plunger all the way down. Then take the needle out.
What Should You Do After a Self-Injection?
Care for your skin. Gently hold an alcohol pad where you injected yourself. Don’t rub your skin with it. If you notice bleeding, put on a bandage.
Safely throw out the needle and syringe or auto-injector pen. Place these in a puncture-proof disposal container right away. You can buy this container at a pharmacy. Or you can use solid items like a coffee can or a leak-proof, closable milk jug.
Keep your needle disposal container out of reach of children and pets. You’ll want to get rid of it when it’s about three-fourths of the way full so it doesn’t overflow and cause someone in your home to accidentally get stuck by a needle. Call up your local trash removal service or health department and ask what you should do to get your container collected by professionals.
Give yourself some TLC. If you’re not bleeding from the shot, give the body part you injected a gentle rub or massage. It could help loosen up your muscles and get the medication moving through your body.
If the spot where you injected yourself hurts a bit, you can put a warm or cold compress on it to get some relief.
When Should You Call the Doctor?
Pick up the phone if your skin looks like it’s having a reaction where you gave yourself the shot.
Some symptoms of a reaction are:
Call 911 for any symptoms of a severe or anaphylactic reaction. This includes any:
What if You Have Arthritic Hands or Fingers?
If RA affects your hands or fingers, that could make it hard to give yourself injections.
Occupational therapy sessions or squeezable devices help improve some people’s grip strength. But if grip strength is a problem for you, then giving yourself injections might not be a great idea for you, Bose says.
It’s possible, though, to have a family member or a close friend give you your injections after a nurse shows them how, she says. Most biologic-makers have an assistance or education program in which a nurse can walk you and your loved one through the process of giving injections. Your doctor may be able to help connect you with one of these programs.
If you and your doctor decide self-injections aren’t a good fit for you, the doctor might recommend that you try another treatment option, like in-office drug IVs, Bose says. A big advantage of these is that you can kick back while a medical professional does the rest.
