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Practice · Administration

A partial dose because the pen emptied mid-injection

Solved
Solved by g.tamm in post #9
Worth separating two things that post #5 runs together. Bleeding at the injection site: normal and usually minimal. A little blood at the needle site after withdrawal is not a reason to assume you lost a significant dose. The needle passed through tissue and there is a small amount of bleeding in the tract.

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IRenaudinTL2Member6 Jan 2026#1

A partial dose because the pen emptied mid-injection Writing it up because I had to work it out twice and would rather nobody else did.

Practical question with the units stated, because I have seen how quickly these go wrong without them.

I have a 2 mg vial of semaglutide and I am working to a 1.0 mg step. My syringes are U-100 insulin syringes, 1.0 mL barrel.

I can do the arithmetic and I have done it twice, getting the same answer both times, but I would like someone to check the reasoning rather than the number — specifically whether I have thought about the residual volume correctly, and whether the graduation I am landing on is one a person can actually read.

13 likes 7mo
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DSakamotoTL3Regular6 Jan 2026#2

Air bubbles in a subcutaneous injection: the honest risk assessment is low. Tiny air bubbles in subcutaneous tissue do not behave like an air embolism in a blood vessel. A few air bubbles are not a reason to restart the entire injection.

1 like 7mo
AW
am.wikstromTL2 Moderator6 Jan 2026#3
DSakamoto, post #2: Air bubbles in a subcutaneous injection: the honest risk assessment is low. Tiny air bubbles in subcutaneous tissue do not behave like an air embolism in a blood vessel. A few air bubbles are not a reason to restart the entire injection. Go to post

I read the opening post twice before replying, because I had assumed the opposite.

Angle of injection: 90 degrees into pinched tissue ensures subcutaneous placement. It is not always necessary and shallower angles can work, but 90 degrees into a small pinch is the safest technique to learn first.

33 likes in reply to #2 7mo
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IbrahimoviTL2Member6 Jan 2026#4
am.wikstrom, post #3: I read the opening post twice before replying, because I had assumed the opposite. Angle of injection: 90 degrees into pinched tissue ensures subcutaneous placement. It is not always necessary and shallower angles can work, but 90 degrees into a small pinch is the safest technique to learn first. Go to post

I disagree with the reply above, and I think the disagreement is substantive rather than terminological.

The distinction being drawn does not survive when you look at the published data for this specific question. I would be glad to be shown wrong on this, because the version I am arguing against is more convenient.

17 likes in reply to #3 7mo
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b.brandtTL2 Moderator6 Jan 2026#5

Pinch or no pinch: the decision depends on needle length and on your own anatomy. A longer needle (8 mm and up) reaches subcutaneous tissue easily without a pinch. A shorter needle (4-6 mm) is safer with a gentle pinch. The pinch size matters less than people think; the injection angle matters more.

3 likes 7mo
CN
cannula_notesTL2Member6 Jan 2026 · edited#6

A site rotation scheme that actually works: abdomen, outer thigh, back of arm, outer hip. Rotate through them in order, move a minimum 2 cm between consecutive sites, note the site with each dose. If a local reaction appears you have the history. If you rotate properly you will not get lipohypertrophy from overuse of one area.

0 likes 7mo
TL
t.lindqvistTL2 Moderator6 Jan 2026#7
IRenaudin, post #1: A partial dose because the pen emptied mid-injection Writing it up because I had to work it out twice and would rather nobody else did. Practical question with the units stated, because I have seen how quickly these go wrong without them. I have a 2 mg vial of semaglutide and I am working to a 1.0 mg step. My syringes are U-100 insulin… Go to post

Coming back to post #5, because the follow-up matters more than the original answer.

Practical note that does not fit anywhere else. Whatever you conclude from this topic, write down what you did and when. The single most useful thing in your own records is not any individual result; it is that they are dated and consecutive.

24 likes in reply to #1 7mo
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MSaarinenTL3Regular6 Jan 2026#8

Picking up post #5: that is the part I would want checked first.

A genuinely late dose: the labelling generally says that if the next dose is more than a couple of days away, take it as soon as you notice. If the next dose is close, skip it and resume the schedule. The reasoning follows from the long half-life; you are perturbing a slowly moving average.

11 likes 7mo
GT
g.tammTL2 Moderator Solution7 Jan 2026#9

Worth separating two things that post #5 runs together.

Bleeding at the injection site: normal and usually minimal. A little blood at the needle site after withdrawal is not a reason to assume you lost a significant dose. The needle passed through tissue and there is a small amount of bleeding in the tract.

8 likes 7mo
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NicolaidesTL3Regular7 Jan 2026#10

post #9 is right about the mechanism and I think understates the practical bit.

Leak-back after withdrawal: a small amount of liquid on the skin after withdrawal is ordinary. Whether you lost a "meaningful" dose depends on concentration and your target dose, but some leak-back is universal and does not need to be treated as an error.

0 likes 7mo
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PSkarbekTL3Regular7 Jan 2026#11

post #10 answers the question as asked. The question underneath it is different.

Drawing up with one needle and injecting with another: a reasonable practice if you have extra needles. Fresh needle for injection reduces tissue drag and can decrease discomfort. Not necessary, but not harmful either.

0 likes 7mo
TA
t.abubakarTL2 Moderator7 Jan 2026#12

On post #8 — agreed on the reasoning, with one qualification.

Injecting into an area that has become firm: lipohypertrophy — thickened fatty tissue from repeated injection in one area — changes local tissue absorption. Avoid injecting into areas that are noticeably firm or lumpy and allow those areas to recover for at least a few months.

2 likes 7mo
VK
v.krastevTL2 Moderator7 Jan 2026 · edited#13
PSkarbek, post #11: post #10 answers the question as asked. The question underneath it is different. Drawing up with one needle and injecting with another: a reasonable practice if you have extra needles. Fresh needle for injection reduces tissue drag and can decrease discomfort. Not necessary, but not harmful either. Go to post

For anyone arriving from a search: the marked solution above is the direct answer, and the replies underneath it add the caveats that make it safe to use.

12 likes in reply to #11 7mo
MA
m.achebeTL2 Moderator7 Jan 2026#14

Injection discomfort: comes from needle gauge (finer = less discomfort), volume (smaller = less discomfort), temperature (room temperature or warmed is less uncomfortable than cold), and technique (smooth, purposeful injection is less uncomfortable than hesitant). All four are under your control.

26 likes 7mo
CD
c.dahlbergTL2 Moderator7 Jan 2026#15

post #14 is right about the mechanism and I think understates the practical bit.

Bleeding at the injection site: normal and usually minimal. A little blood at the needle site after withdrawal is not a reason to assume you lost a significant dose. The needle passed through tissue and there is a small amount of bleeding in the tract.

0 likes 7mo
JB
j.baptistaTL2 Moderator7 Jan 2026#16

A site rotation scheme that actually works: abdomen, outer thigh, back of arm, outer hip. Rotate through them in order, move a minimum 2 cm between consecutive sites, note the site with each dose. If a local reaction appears you have the history. If you rotate properly you will not get lipohypertrophy from overuse of one area.

0 likes 7mo
MR
m.rasmussenTL2 Moderator7 Jan 2026#17
j.baptista, post #16: A site rotation scheme that actually works: abdomen, outer thigh, back of arm, outer hip. Rotate through them in order, move a minimum 2 cm between consecutive sites, note the site with each dose. If a local reaction appears you have the history. If you rotate properly you will not get lipohypertrophy from overuse of one area. Go to post

Injecting into an area that has become firm: lipohypertrophy — thickened fatty tissue from repeated injection in one area — changes local tissue absorption. Avoid injecting into areas that are noticeably firm or lumpy and allow those areas to recover for at least a few months.

8 likes in reply to #16 7mo
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z.onwukaTL2 Moderator7 Jan 2026#18
Ibrahimovi, post #4: I disagree with the reply above, and I think the disagreement is substantive rather than terminological. The distinction being drawn does not survive when you look at the published data for this specific question. I would be glad to be shown wrong on this, because the version I am arguing against is more convenient. Go to post

I read post #16 twice before replying, because I had assumed the opposite.

Two things before anyone answers the substance.

First, the context in the first post is clear and specific. Second, the question is framed so that an answer can actually address it. Both are the norm here and both matter more than they sound.

19 likes in reply to #4 7mo
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ambient_reviewTL3Regular7 Jan 2026#19

For anyone arriving from a search: the marked solution above is the direct answer, and the replies underneath it add the caveats that make it safe to use.

27 likes 7mo
PO
pe.onwukaTL2 Moderator7 Jan 2026#20

Angle of injection: 90 degrees into pinched tissue ensures subcutaneous placement. It is not always necessary and shallower angles can work, but 90 degrees into a small pinch is the safest technique to learn first.

0 likes 7mo
SS
steady_stateTL3Regular7 Jan 2026#21

Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing.

The correction was fair and I had been repeating something I had not checked carefully enough.

0 likes 7mo
NC
n.cabreraTL2 Moderator7 Jan 2026 · edited#22

Air bubbles in a subcutaneous injection: the honest risk assessment is low. Tiny air bubbles in subcutaneous tissue do not behave like an air embolism in a blood vessel. A few air bubbles are not a reason to restart the entire injection.

21 likes 7mo
SB
sharps_binTL27 Jan 2026#23
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s.vukovicTL2 Moderator7 Jan 2026#24

This follows post #21 rather than contradicting it.

A genuinely late dose: the labelling generally says that if the next dose is more than a couple of days away, take it as soon as you notice. If the next dose is close, skip it and resume the schedule. The reasoning follows from the long half-life; you are perturbing a slowly moving average.

2 likes 7mo
OF
outline_firstTL3Wiki editor7 Jan 2026#25

On post #21 — agreed on the reasoning, with one qualification.

Pinch or no pinch: the decision depends on needle length and on your own anatomy. A longer needle (8 mm and up) reaches subcutaneous tissue easily without a pinch. A shorter needle (4-6 mm) is safer with a gentle pinch. The pinch size matters less than people think; the injection angle matters more.

30 likes 7mo
SO
se.okaforTL2 Moderator7 Jan 2026#26

Leak-back after withdrawal: a small amount of liquid on the skin after withdrawal is ordinary. Whether you lost a "meaningful" dose depends on concentration and your target dose, but some leak-back is universal and does not need to be treated as an error.

15 likes 7mo
CT
cannula_traceTL3Regular7 Jan 2026#27
sharps_bin, post #23: Drawing up with one needle and injecting with another: a reasonable practice if you have extra needles. Fresh needle for injection reduces tissue drag and can decrease discomfort. Not necessary, but not harmful either. Go to post

Injection discomfort: comes from needle gauge (finer = less discomfort), volume (smaller = less discomfort), temperature (room temperature or warmed is less uncomfortable than cold), and technique (smooth, purposeful injection is less uncomfortable than hesitant). All four are under your control.

6 likes in reply to #23 7mo
GA
g.amankwahTL2 Moderator7 Jan 2026#28

Cold solution and stinging: warming the vial in your hands for a minute before injection reduces the stinging sensation substantially. This is the simplest thing to try if injections are uncomfortable.

1 like 7mo
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BirkelandTL3Regular8 Jan 2026 · edited#29

A genuinely late dose: the labelling generally says that if the next dose is more than a couple of days away, take it as soon as you notice. If the next dose is close, skip it and resume the schedule. The reasoning follows from the long half-life; you are perturbing a slowly moving average.

0 likes 7mo
VR
v.rautioTL2 Moderator8 Jan 2026#30

post #29 is right about the mechanism and I think understates the practical bit.

Pinch or no pinch: the decision depends on needle length and on your own anatomy. A longer needle (8 mm and up) reaches subcutaneous tissue easily without a pinch. A shorter needle (4-6 mm) is safer with a gentle pinch. The pinch size matters less than people think; the injection angle matters more.

0 likes 7mo