How to Give Vitcofol Injection
Vitcofol (folate) injections should be administered intramuscularly using proper IM injection technique, with particular attention to site selection, needle length, and aspiration considerations to ensure safe and effective delivery.
Preparation
- Verify the medication label before drawing up the dose to avoid administering the wrong medication 1
- Clean your hands thoroughly before handling the injection supplies 1, 2
- Gather all necessary supplies including the vial, appropriate syringe and needle, alcohol swabs, and sharps container 2
- Draw air equal to the dose into the syringe and inject it into the vial first to avoid creating a vacuum 1, 2
- Inspect the drawn medication for air bubbles and remove them by flicking the upright syringe 1
Site Selection for IM Injection
- Preferred sites for intramuscular injection include the deltoid muscle (upper arm), vastus lateralis (thigh), and ventrogluteal area 1
- Avoid the dorsogluteal site when possible due to its proximity to the gluteal artery; if this site must be used, aspiration is recommended 3
- Inspect the injection site before administering and ensure it is clean and free from lipohypertrophy, inflammation, edema, or infection 1
Injection Technique
- Clean the injection site with an alcohol swab and allow it to dry completely before injecting 1, 2
- For most adults, grasp a fold of skin lightly and inject at a 90-degree angle 1
- Thin individuals or children may need to pinch the skin and inject at a 45-degree angle to avoid intramuscular injection that is too deep 1
- Insert the needle smoothly through the skin in one motion—not too slowly or forcefully, as pain fibers are in the skin 1
- Aspiration is generally not necessary for most IM injection sites (deltoid, vastus lateralis, ventrogluteal) and can increase pain; however, aspirate if using the dorsogluteal site 1, 3
- Inject slowly to minimize discomfort 1
Post-Injection Care
- Withdraw the needle smoothly after complete delivery of the medication 1
- Dispose of the needle and syringe immediately in a sharps container 1
- If bleeding or bruising occurs, reassure the patient this does not affect medication absorption 1
Important Clinical Considerations
- Always treat vitamin B12 deficiency before initiating folic acid treatment to avoid masking B12 deficiency and precipitating subacute combined degeneration of the spinal cord 1
- For treatment of folate deficiency after excluding B12 deficiency, oral folic acid 5 mg daily for a minimum of 4 months is typically recommended, though IM administration may be necessary in malabsorption cases 1
- Do not reuse needles—use a sterile, new needle with each injection to prevent tissue damage, infection risk, and needle deformation 1