How to Give Lovenox Injections
It should be noted that injection techniques and preferences vary. The following instructions may be useful for many people:
- Have everything you need ready (the prefilled Lovenox syringe, an alcohol swab, and a sharps container).
- Wash your hands thoroughly.
- Pick a spot to inject. The standard sites are on the abdomen, where you can "pinch an inch." Make sure to avoid the belly button area by a few inches or so. Try to alternate sides (left side one day, right side the next).
- Vigorously cleanse the area with an alcohol swab. It is worth buying a box of alcohol swabs. They are very inexpensive, portable, and much more sterile and convenient than using a cotton ball and a bottle of rubbing alcohol.
- While you wait for the alcohol to dry, get the injection ready. First remove it from its packaging. Then remove the protective needle cover. This is actually easier said than done. It is often easier to remove the tip if you slightly pull back on the syringe plunger first. This seems to relieve the suction, making the tip much easier to remove and preventing the drug from spraying out when you remove the tip.
- If you have been instructed to adjust the dosage, do so now by squirting out the necessary amount into a sink or tissue. However, this is rarely necessary, so do not worry about dosing adjustments unless you have been specifically instructed to do so. Most people use an entire syringe for each dose.
- Pinch the skin and fat at your chosen injection site. You will be inserting the needle into the skin and fat layers. Pulling slightly at the skin and fat helps to make sure that you do not inadvertently inject into a muscle. You will keep the skin and fat pinched throughout the entire process, until after the needle is removed.
- Do not worry too much about injecting into a small blood vessel; doing so is not dangerous, although it may increase the risk of bruising.
- Do not worry about the air bubble in the syringe. It should not be removed and should be injected along with the medication.
- Take a deep breath and insert the needle in as far as it goes (all the way to the hub). Some people like to "poke around" a little and find a less sensitive area, while others simply always goes with the first try. Some people like to jab it in quickly like a dart, while others prefer the control of a gradual insertion.
- Inject the medication very slowly. You will likely feel resistance. If so, proceed even more slowly.
- Take another deep breath. The worst is over. Wait a few seconds before removing the needle slowly. This seems to help prevent bleeding and bruising.
- Firmly push down on the plunger to activate the needle protection device. When you do this, a little medication will spray out, so aim it in an appropriate direction. Dispose of the entire needle and syringe in a sharps container.
- The large size of the Lovenox prefilled syringes make them too large to fit in many standard sharps containers, which are built for tiny insulin syringes. Any hard-sided container with a tight-fitting lid (appropriately labeled) will do. Many patients find that an empty plastic milk jug works well.
- Even with the best injection technique, large bruising, painful injections, and lumps sometimes occur, seemingly at random. However, if you always have a painful, large lump, you may to need seek advice about improving your injection technique.
This particular injection technique has been found to be useful by this particular author. However, always follow the instructions your healthcare provider has given you for your particular situation.
If you will be using the multi-dose vials (instead of the prefilled syringes), the steps will be slightly different. However, almost all people use the prefilled syringes.