1. Obtain one dose of injectable, needle, and syringe
Needle with bottle
  • 25 mg MPA/estradiol cypionate or 50 mg NET-EN/estradiol valerate, intramuscular injection needle, and 2 ml or 5 ml syringe. (NET-EN/estradiol valerate is sometimes available in prefilled syringes.)
  • For each injection use a disposable auto-disable syringe and needle from a new sealed package (within expiration date and not damaged), if available.
2. Wash
  • Wash hands with soap and water, if possible.
  • If injection site is dirty, wash it with soap and water.
  • No need to wipe site with antiseptic.

If using a prefilled syringe, skip to step 5.

3. Prepare vial
  • MPA/estradiol cypionate: Gently shake the vial.
  • NET-EN/estradiol valerate: Shaking the vial is not necessary.
  • No need to wipe top of vial with antiseptic.
  • If vial is cold, warm to skin temperature before giving the injection.
4. Fill syringe
  • Pierce top of vial with sterile needle and fill syringe with proper dose.
5. Inject formula
  • Insert sterile needle deep into the hip (ventrogluteal muscle), the upper arm (deltoid muscle), the buttocks (gluteal muscle, upper outer portion), or outer (anterior) thigh, whichever the woman prefers. Inject the contents of the syringe.
  • Do not massage injection site.

Four spots for giving injections

6. Dispose of disposable syringes and needles safely

Safe sharps disposal

  • Do not recap, bend, or break needles before disposal.
  • Place in a puncture-proof sharps container.
  • Do not reuse disposable syringes and needles. They are meant to be destroyed after a single use. Because of their shape, they are very difficult to disinfect. Therefore, reuse might transmit diseases such as HIV and hepatitis.
  • If reusable syringe and needle are used, they must be sterilized again after each use (see Infection Prevention in the Clinic, in Chapter 26 – Family Planning Provision).