Offering support for those with Addison’s disease
and other forms of Adrenal Insufficiency
The Canadian Addison Society
2 Palace Arch Drive
Toll free: 1-888-550-5582
Injectable hydrocortisone is given intramuscularly, which means that it is injected into a large muscle. When giving yourself an injection, the easiest and best place to give it is in the thigh on the same side as your dominant hand (for example, the right thigh if you are right-handed). Adults should always carry injectable medication with them, when they travel. If you have a child with AI, you or the child’s caregiver must always carry the child’s medication. If the child is in school, the school nurse must know about your child’s condition.
The following information is based on instructions obtained from The Cares Foundation.
1. Wash your hands
2. Assemble your equipment:
a) Alcohol Wipes (2)
b) Guaze Pads
c) Syringe (with 20 or 22 gauge needle
d) Hydrocortisone vial
3. Mix the medication vial by pushing down on top of the vial to release the cork.
Make sure all the liquid drains into the medication powder portion of the vial.
4. Roll the vial in your hands to mix the medication solution well yet avoiding the creation of bubbles.
5. Use alcohol to clean the rubber stopper on the vial.
6. Take the cap off the syringe needle and insert the needle into the vial.
a) Pull the plunger back to the 2ml mark
b) Turn the vial upside down
c) Insert the needle into the vial
d) Push the plunger in. This will inject air into the vial and make it easier to withdraw the liquid.
7. Draw up the medication. Adults should use all the medication in the vial For a child, use the dose prescribed by the doctor.
8. Hold the syringe with the needle up and expel air from the syringe by pushing up on the plunger. If there are bubbles, tap on the wall of the syringe with your fingernail. The bubbles should rise to the top and the air can be expelled.
9. Replace the needle cap.
10. Select the site for your injection.
To inject yourself safely, become familiar with your body. Uncover your thigh and look at it. Now, draw an imaginary line in the middle of your thigh to divide it in half lengthwise. The outer portion is where you will be injecting.
Now, imagine your thigh divided into three equal portions, from the knee to the hip. The outer portion of the inner third of your thigh is where you will do the injection.
11. Use alcohol to cleanse the injection site on your skin.
Allow alcohol to dry.
12. Remove the cap from the needle. Hold the syringe like a dart.
13. Using your thumb and first two fingers, spread your skin while pushing down lightly.
14. Dart the needle into the thigh injection site, going straight in at a 90-degree angle.
15. Hold the syringe in place. Pull back the plunger to make sure you are not injecting into a large blood vessel.
If blood appears in the syringe, pull the needle back a little (1/8 inch) and pull back the plunger. If blood does not come back, you can inject the medication.
16. After injecting the medication, place tissue or gauze near the needle, and pull the needle out quickly at the same angle.
17. Massage the injection site gently.
18. Place the syringe and needle in a hard, unbreakable container (such as an empty coffee can with a lid) before disposing of it.
19. Call your local doctor. OR
20. Present yourself to the nearest emergency centre or call 911.
21. Inform the responding emergency personnel/doctor that you have given yourself a hydrocortisone injection.