How to give an intramuscular (IM) injection

An intramuscular (IM) injection delivers medication into the muscle rather than under the skin. Several Belle medications are given this way, including MIC-B12 (MICC). The technique is different from a GLP-1 injection, which is subcutaneous.

Watch the full walkthrough below, then review the step-by-step guide.

What You'll Need

Included in your shipment:

• Your medication vial
• Syringes with a 25-gauge, 1-inch IM needle attached
• An alcohol swab

MIC+B12 goes into the muscle, so it needs the 1-inch needle that comes in your box. If injecting feels hard, message us and a nurse can walk you through it on a call.

You provide these yourself. They are not included in any Belle shipment:

• Gauze or a cotton ball
• A sharps container for safe disposal

Approved IM Injection Sites

• Outer thigh: the middle third of the outer upper leg. This is the easiest site for self-injection.
• Deltoid (upper arm): middle of the outer arm, 2 to 3 finger widths below the shoulder. Best for volumes up to 1 mL.

Rotate sides and sites with each dose. Avoid bruised, scarred, or inflamed areas.

Step-by-Step Technique

• Wash your hands and check your medication label.
• Choose your site and clean it with an alcohol swab. Let it dry completely.
• Draw up your dose per your provider's instructions.
• Insert the needle at a 90 degree angle in one quick motion.
• Pull back gently on the plunger before injecting. If you see blood, withdraw and choose a new site.
• Inject slowly and steadily.
• Withdraw the needle and apply light pressure with gauze if needed.
• Dispose of the needle in a sharps container. Do not place needles in regular trash.
• Note your next rotation spot so you're ready for your next dose.

IM vs. Subcutaneous: What's the Difference?

GLP-1 medications (semaglutide and tirzepatide) are subcutaneous, meaning they go just under the skin using a shorter needle at a 45 to 90 degree angle. IM injections use a longer needle at a 90 degree angle and go into the muscle.

Do not use the same technique for both. If you accidentally give a MIC-B12 dose under the skin instead of into the muscle, do not repeat the dose or add extra to make up for it. Message us before your next dose so your care team can tell you how to go on.

The Pharmacy Hub recommends administering MIC+B12 by intramuscular injection only. Subcutaneous injection is not advised, because absorption is slower and less reliable, which can mean reduced effectiveness and more side effects.

When to Contact Us

• Persistent redness, swelling, or pain at the injection site lasting more than 24 to 48 hours
• Signs of an allergic reaction: rash, difficulty breathing, swelling of the face
• Any concern about your dose, technique, or needle placement

Reach out through your patient portal and our team will help you from there.

If you have a reaction at the injection site: mild redness or irritation right after injecting is normal. Rotate away from that site for your next dose and apply a cold compress to reduce redness or swelling. Contact your provider through the portal if the redness spreads, worsens, or has not settled within a day or two. Seek immediate medical attention for signs of a severe allergic reaction such as swelling, difficulty breathing, or hives.