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Medically reviewed byDr. Rachel Morrison, MD, ABOM·Updated July 2026
Patient Guide

Medication preparation & injection instructions

Your medication arrives as a freeze-dried (lyophilized) powder that you'll reconstitute with bacteriostatic water. This guide walks you through every step - from mixing to injection.

Your Kit

What's included in your shipment

Everything you need arrives in one temperature-controlled package. Here's what's inside and what each item is for.

Medication Vial

Lyophilized (freeze-dried) peptide powder. White or off-white cake/powder at the bottom of the vial. Check the label for total mg content.

Bacteriostatic Water (BAC)

Sterile water containing 0.9% benzyl alcohol as a preservative. Used to dissolve the peptide powder. Typically 10 mL or 30 mL vial.

Insulin Syringes

1 mL (100 unit) insulin syringes with fine-gauge needles (29-31G). Used for both reconstitution and injection. Individually sealed.

Alcohol Swabs

70% isopropyl alcohol wipes. Used to sterilize vial tops and injection site before every use. Use a fresh swab each time.

Sharps Container

FDA-approved container for safe disposal of used needles and syringes. Never throw syringes in regular trash.

Dosing Card

Quick-reference card with your personalized dosing instructions, concentration, and the amount to draw for each dose.

Step-by-Step

How to reconstitute your medication

Reconstitution means dissolving the freeze-dried powder with bacteriostatic water to create an injectable solution. You only do this once per vial - after mixing, the vial is ready for multiple doses.

Wash your hands thoroughly

Wash with soap and warm water for at least 20 seconds. Dry with a clean towel. Work on a clean, flat surface with good lighting. Gather all supplies before starting.

Sterilize both vial tops

Use a fresh alcohol swab to wipe the rubber stopper on both the medication vial and the bacteriostatic water vial. Let the alcohol air dry completely - about 10-15 seconds. Do not blow on them.

Always swab vial tops before every needle insertion, even if you just opened them.

Draw bacteriostatic water into the syringe

Using a new insulin syringe, draw the amount of bacteriostatic water specified on your dosing card. Push the needle through the center of the BAC water vial's rubber stopper, invert the vial, and slowly draw the water into the syringe. Remove air bubbles by gently flicking the syringe and pushing them out.

Common amounts: 1 mL or 2 mL of BAC water - check your dosing card. The amount of water determines your concentration and how many units you'll draw per dose.

Add water to the medication vial - gently

Insert the needle into the medication vial through the rubber stopper. Aim the needle at the inside wall of the vial, not directly at the powder. Slowly depress the plunger to let the water trickle down the glass wall and onto the powder. Do NOT squirt water directly onto the powder - this can damage the peptide.

Slow and gentle. Let the water run down the side of the vial. Think "drizzle," not "spray." This preserves the peptide's molecular structure.

Let it dissolve - do NOT shake

Remove the syringe. The powder will begin dissolving on its own. Never shake the vial - shaking denatures the peptide and reduces potency. You can gently roll the vial between your palms or tilt it slowly back and forth if needed. Most peptides dissolve completely within 5-10 minutes.

The solution should be clear and colorless when fully dissolved. If it's cloudy, contains particles, or is discolored, do not use it - contact your care team.

Label the vial

Write the date of reconstitution and the concentration (e.g., "5mg/2mL = 2.5mg/mL") on the vial or on a piece of tape attached to it. This helps you track potency and expiration. Reconstituted medication must be used within 28 days.

Store in the refrigerator

Place the reconstituted vial in your refrigerator at 36-46°F (2-8°C). Do not freeze. Keep away from light. Do not store in the refrigerator door (temperature fluctuates). The center shelf is ideal.

Set a phone reminder for 28 days out - that's when the reconstituted medication expires, even if there's solution remaining.
Dose Calculator

How much to draw

Use this calculator to determine how many units to draw on your insulin syringe for your prescribed dose. Your dosing card has these numbers, but this tool helps you double-check.

Dose Calculator

mg
mL
mg
Enter your values above

Example: 5 mg vial + 2 mL BAC water = 2.5 mg/mL concentration. For a 0.25 mg dose, draw 0.10 mL (10 units on an insulin syringe).

Injection Technique

How to inject

Subcutaneous injection - just under the skin. It's simpler than it sounds, and the needles are very fine (29-31 gauge). Most patients report minimal to no pain.

Draw your dose from the reconstituted vial

Swab the vial top with alcohol. Using a new syringe, draw the number of units indicated on your dosing card (or calculated above). Remove air bubbles by gently flicking the syringe barrel and pushing the plunger until a tiny drop appears at the needle tip.

Choose and clean your injection site

Rotate between three areas each week: abdomen (at least 2 inches from your navel), front of thigh (middle third), or back of upper arm. Clean the area with an alcohol swab in a circular motion. Let it air dry.

Keep a simple rotation: Week 1 = left abdomen, Week 2 = right thigh, Week 3 = left thigh, Week 4 = right abdomen. Repeat. Avoid injecting into the same spot twice in a row.

Pinch and inject

With your non-dominant hand, gently pinch a fold of skin at the injection site. With your dominant hand, insert the needle at a 90-degree angle (straight in) - the needles are short enough for subcutaneous depth. Push the plunger slowly and steadily until the syringe is empty. Wait 5-10 seconds before removing the needle.

Don't aspirate (pull back) - it's not necessary for subcutaneous injections and just makes the process longer. A small drop of blood or medication at the injection site is normal.

Dispose of the syringe safely

Immediately place the used syringe into your sharps container. Do not recap the needle - this is the most common cause of accidental needle sticks. Never throw syringes in regular trash or recycling. When your sharps container is ¾ full, seal it and dispose at a pharmacy or local drop-off point.

Storage

Storage guidelines

Before Reconstitution

Store in refrigerator (36-46°F / 2-8°C). Can be kept at room temperature (up to 77°F / 25°C) for up to 30 days. Keep away from direct sunlight. Do not freeze.

After Reconstitution

Must be refrigerated. Use within 28 days of mixing. Do not freeze reconstituted solution. Label with the date you mixed it. Discard any remaining solution after 28 days.

Important Safety Information

  • Never shake the vial - this destroys the peptide. Gently roll or tilt only.
  • Use bacteriostatic water only - regular sterile water lacks preservative and allows bacterial growth.
  • Do not use if the solution is cloudy, discolored, or contains visible particles after reconstitution.
  • Discard reconstituted medication after 28 days, even if solution remains.
  • Always use a new syringe for each injection - never reuse needles.
  • Store reconstituted vials upright in the refrigerator - not the freezer, not the door.
  • Contact your care team immediately if you experience severe injection site reactions, allergic symptoms, or persistent nausea/vomiting.
  • Keep all medication out of reach of children and pets.
Common Questions

Preparation FAQ

What does "lyophilized" mean?
Lyophilization (freeze-drying) removes water from the medication to create a stable powder that can be stored longer and shipped safely. When you add bacteriostatic water, you're simply reconstituting - restoring the medication to its active liquid form. The process doesn't change the medication's effectiveness.
Why bacteriostatic water and not regular water?
Bacteriostatic water contains 0.9% benzyl alcohol, which prevents bacterial growth inside the vial. Since you'll be drawing multiple doses from the same vial over several weeks, this preservative is essential for safety. Regular sterile water (without preservative) should only be used for single-use vials and must be discarded after one use.
How do I know if the powder dissolved correctly?
A properly reconstituted solution is completely clear and colorless - like water. There should be no visible particles, cloudiness, or discoloration. If the solution looks off, don't use it. Small bubbles are normal and harmless; undissolved chunks of powder are not. If powder remains after 15 minutes of gentle rolling, contact your care team.
I accidentally shook the vial - is it ruined?
A brief, light shake is unlikely to cause significant damage. Vigorous or prolonged shaking can denature (break down) the peptide, reducing its effectiveness. If the solution remains clear with no foam or particles, it's likely fine. If you see persistent foam, clouding, or particles, contact your care team for a replacement.
Can I travel with my medication?
Yes. Reconstituted medication must stay refrigerated, so use an insulated travel case with ice packs. Unreconstituted (powder) vials can travel at room temperature for up to 30 days. Keep your prescription label and physician's letter with your medication when flying. TSA allows syringes and injectable medication with proper documentation.
The injection hurt - is that normal?
Most patients report little to no pain with insulin-gauge needles. If it stings, common causes include: injecting too quickly (slow down), cold medication (let it warm to room temperature for 15-20 minutes before injecting), or injecting into a tense muscle (relax and pinch the skin fold). Mild redness or a small bump at the injection site is normal and resolves within hours.
Average response time under 2 hours

Questions about your medication?

Your care team is available 7 days a week to answer preparation, dosing, and injection questions.

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