From the Guidelines
You should contact your healthcare provider immediately for guidance if you're concerned about injecting Metoris (methotrexate) too low on your thigh. The proper injection site for methotrexate in the thigh is crucial to ensure optimal drug delivery and minimize complications. According to general recommendations on immunization 1, intramuscular injections, such as those for methotrexate, should be administered at a 90-degree angle into the anterolateral aspect of the thigh.
Key Considerations
- Injecting too low on the thigh could potentially affect drug absorption or increase the risk of hitting blood vessels, nerves, or bone.
- Until you speak with your provider, monitor the injection site for unusual swelling, pain, or redness.
- For future injections, ask your healthcare provider to demonstrate the correct technique and location again.
- The thigh should be divided mentally into thirds from hip to knee, with the injection given in the middle third, at least 5 cm (2 inches) above the knee.
Injection Technique
Proper injection technique is essential, and while the provided evidence on insulin administration 1 discusses subcutaneous injections, the principle of avoiding intramuscular injection, especially in the thigh area, is relevant. However, for methotrexate, which is typically administered intramuscularly or subcutaneously depending on the formulation and clinical guidelines, the focus should be on the correct intramuscular technique as described for general immunization practices 1.
From the Research
Potential Risks of Injectable Drug Administration
- Injections of drug products are generally considered safe when performed by qualified personnel, but there always exists a low finite probability of risk with any injectable product by any injectable route of administration 2
- Nurses should take an active approach to patient assessment before injecting medicines, and require a thorough understanding of anatomy and physiology, pharmacological principles and equipment, and potential risks to the patient of injections 3
Risks Associated with Assisted Injection
- Providing injection assistance can result in incidental blood exposures and injury, particularly when injecting in sensitive locations on the body, such as the groin or leg 4
- Missing a vein was significantly associated with higher odds of assisting a leg injection, while getting the recipient's blood on the provider or getting blood on clothes or surfaces was associated with higher odds of assisting a groin injection 4
Complications after Unintentional Intra-Arterial Injection
- Unintentional intra-arterial injection of medication can lead to clinically important sequelae, including paresthesias, severe pain, motor dysfunction, compartment syndrome, gangrene, and limb loss 5
- Normal vascular anatomical proximity, aberrant vasculature, procedurally difficult situations, and medical personnel error all contribute to unintentional cannulation of arteries in an attempt to achieve intravenous access 5
Medical Complications of Injection Drug Use
- The risk of death and the prevalence of hospitalizations in the United States have increased substantially among people who inject drugs, in large part because of the opioid epidemic 6
- Medical complications of injection drug use can be reduced through strategies to reduce harm, although the specific risks and complications associated with injecting in the thigh are not well-documented in the available evidence 6