Injection site rotation: why and how to log it

Where the injections go

Injectable GLP-1 and GIP/GLP-1 medicines are given under the skin (subcutaneously). The exact sites differ between medicines, so your own medicine’s patient leaflet always applies. For example:

• The leaflet for a once-weekly semaglutide medicine names the front of the thighs, the front of the waist (abdomen) or the upper arm as the best places to inject.¹
• For a tirzepatide medicine it is the stomach area (abdomen) at least 5 cm from the belly button, the thigh or the back of the upper arm.²
• For a dulaglutide medicine it is the abdomen or the thigh; another person may inject into the upper arm.⁴

What the leaflets say about rotating sites

The wording differs, but the idea is always the same: don’t keep using the same spot.

• Tirzepatide: you can use the same area of your body each week, but be sure to choose a different injection site within that area. The pen’s instructions for use sum it up: “Change (rotate) your injection site each week.”²
• Dulaglutide: the instructions for use give the same reminder to change the injection site each week.⁴
• Liraglutide (used once a day): the leaflet says to change the place where you inject each day to reduce the risk of developing lumps.³

Why log your injection sites

A week is a long time. With a weekly injection you go through four sites a month, and remembering which one you used last time and the time before that is harder than it sounds. A log answers the question for you: just look at your history.

A record also helps if you notice a change in your skin. You can show your doctor when and where your recent injections went.

How to keep a tidy record

1. Split areas into smaller sites. For example, left and right arm, left and right thigh, and the abdomen divided into four areas. Keep the names the same so your records stay easy to read.
2. Log right after each dose. Date, time, site and a short note if you need one.
3. Check your history before the next dose. You’ll see which site was used last and which hasn’t been used for the longest time. The decision is always yours, guided by the patient leaflet.
4. Stick to one convention for left and right. If you use a picture of a figure, be clear whether it’s a mirror view or a view from outside. In Dávka the figure is your mirror image: your left side is on the left of the screen.

When to talk to your doctor

If you notice changes at an injection site that worry you, such as lumps, pain or redness that doesn’t go away, note them down and discuss them with your doctor or pharmacist.