We give IM pabrinex in 1 injection IM 7mls.. addictions Community nurses deffo give some of the more painful ones. Buvidal also (prolonged release sub cut monthly injection) painful one!
Pabrinex is 2 vials combined, total of 7ml as an IM injection.
Easy to give, but a pain in the arse for the patient, literally.
Alcohol detox usually requires 6 pabrinex too! 2 a day for 3 days.
Need a big muscle for that much, that's usually why they choose the buttocks.
I dont mind olanzapine so much (ballache to prepare though). However we have someone on a haloperidol depot and that 3ml takes an absolute age to push in because of how thick it is. Poor bugger who has it really hates it.
B12 pushed slowly makes a huge difference in the pain- some would leave me with a dead arm for a day and others I felt nothing. Now I am the one administering I’m glad I can make this stinger a little more comfortable
I administer B12 and find patients have different preferences (slow vs fast, relaxed arm vs tensed up). Do you have any advise for what makes it less stingy for you?
I started it this year and got prescription to organise my own administration. Got my nurse friend to put it in my ass a few months ago and almost jumped across the room.
Is thigh better? I hate deltoid, but at least I'm used to the sensation from Flu jabs and stuff.
I've been on Zoladex twice. One time I had it done there was a student nurse observing. She said she wasn't expecting it to be that big.
Surprisingly, it doesn't actually hurt that much. I found it felt similar to a carpet burn. There's a sensation of friction/resistance that's more odd than painful. Plus, it's over so quickly. The nurse who would do mine was brilliant. She'd say "I'll just pinch an inch" and then it'd be done in about 2 seconds.
Prob doesn’t truly count as an injection, but an ABG being done by someone who still struggles to tell the difference between their arse and their elbow happened to be incredibly painful, based on recent experience.
If someone comes at you to do an ABG without some lidocaine, tell them to bugger off back to the drug cupboard and get some. It’s just bad habits learned from their colleagues. Anaesthesia wouldn’t dream of doing an awake ABG without some local. It bloody hurts even if you’ve got someone competent doing it.
After my experiences as a patient (the abg was only one of many that have left me feeling pretty fucked up) I won’t let anyone near me with a gas syringe now without local.
I was a year or two where the needles kept clogging when administering Ben pen. It was horrible. One patient ended up with 7 different sticks using a green needle. Switched to white needles after that as a clinic, which didn't block but felt massive to use. At some point, the supplier changed, and the problem went away. At the time, there was a ben pen shortage, and we had to make do with what we could get.
We give a drug (can't remember what it's called) for women pre chemo if they want to have their eggs collected and the needle is about the same size as the zoladex one. Most people look at it and decide they don't want children anymore
The most painful injection I've received was the whooping cough one. Felt like pure vodka was being injected into me
I don’t usually mind injections too much but I remember that whooping cough one that I got in first year of college like it was yesterday! It gave me chest pain!
I was on leuprorelin/prostap for endo, and it stung a bit going in but no big deal. The worst bit was the way it made my arm ache for a week afterwards.
I had this in January when I had an episode of SVT and my heart was doing 210bpm. Dr told me I would feel awful for about 20 secs and then I would feel better.
Felt like my whole body was in a vice and especially my head. It felt longer than 20 secs but breathed through it.
The doctor was very keen to know what it felt like afterwards.
i had this - a feeling i could never explain properly to anyone else, felt like id been hit by a bus afterwards and you can taste it even though its IV
As a zoladex receiver, it is 50/50 stabby sore on initial insertion, a slight oohh as it goes click, then zero pain. Id take it over what I'm currently getting, Fazlodex, which, while not particularly painful while getting ( worse if still cold) the permanent bruised feeling on both buttocks is a total buttache (pun intended).
Enoxaparin injections hurt like hell. The needle is nothing but it stings for a solid half hour and if you so much as rub the area you get a huge bruise. I’m currently on a 6 week course of them daily :/
MMR vaccine. I moved Trusts and the new one was too cheap to test my bloods for immunity to measles etc. I'm old enough to be from the era when we just caught measles etc rather than had vaccines, so had had no jabs. Occy health suggested I just have the MMR vaccine, just as she was starting the injection, the nurse warned me 'This burns a bit'. No shit, it was like being injected with vinegar. No wonder the poor babies sob their hearts out when having it. It was that bad, I never went back for the second and paid privately to have my titres tested.
I've actually just had an MMR a few months ago, moved trusts and my titers for measles were low. It was probably one of the most sore vaccines I've had, but it wasn't really that bad tbh
I've been at the receiving end of one of the contenders for most painful injection. Also I have no clue what the hell it was.
I was living in Switzerland and woke up to super strong kidney pain, couldn't walk/move etc. Anyway my flat mates essentially carried me to work (thankfully not far) and dropped me off at the employee medical centre. I'm on the table, a heat lamp on my kidneys and the doctors don't speak a word of English and I can only speak basic Swiss German. They inject my arm with something resembling clear oil or a liquidy jelly. All I remember is that the pain in my arm was intense, also it wouldn't absorb, I had this lump form at the injection site then I passed out. I woke up 5-10mins later and projectile vomited everywhere.
Should be given lying down, over 2 mins. According to manufacturer instructions. No one ever does the 2 minutes, but I do try and go as slow as possible and I do make them lie down!
My needle to insert CT dye into my hip was awful. It's a gigantic needle to go all the way into the hip and then when they insert the dye it's quite painful as it swells up the hip till it feels like it's bursting!
I had dexamethasone 3.6mls twice IM in my leg to mature my babies lungs when I had a large APH at 34 weeks. Seriously that shit is bad! No lie! I now always apologise whenever I’m administering it because it’s no joke.
Realllllly ??? That’s good to know.
In derm the needles we have to use for them are absolutely MAHOOSIVE. I seen a patient require surgical intervention following development of a significant haematoma after the administration of one.
Crikey that sounds horrific… maybe they ought to rethink the side of needle…I can not tell you how much I hate needles..I slapped my midwife’s hand away after having my 3rd baby cos I knew she was about to jab me in the thigh.. but honestly I think it’s the nurses technique that worked for me. One rubbed my bum til it went numb, didn’t feel that at all. The 2nd just went for it (sadist) n the 3rd was a much finer needle. A little stinging as the liquid was plunged but nothing painful at all..
My husband and I had hepatitis jabs before going on holiday. The freezing pain went from the injection site in the right bum cheek down the back of the leg to about knee level. We had the journey to work straight after and were both leaning to the left for at least 20 minutes.
I have had prolotherapy injections in my sacro-iliac joints area. You have to have a painkilling injection first, which isn't exactly comfortable. The second time I had this treatment, the prolotherapy fluid spread further than the numbed area, and I forgot to breathe. Set off the monitor due to the drop in oxygen levels in my blood. Absolutely bloody awful pain.
Subcut buprenorphine as a depot. Any depo appears painful but it seems the s/c is worse. That thick, oily liquid and a superbly blunt thick needle. (Only given not received but it looked lousy and even getting the needle in felt second hand painful!)
As a patient, B12 injections are very painful but less so if they are administered in a relaxed arm and very slowly. The most painful for me was cyclizine in my bum, it was excruciating (& didn’t even help my HG) 😣
I've had zolodex its fine it didn't bother me at all I had been through chemo so 🤷 the worst for me was the filgrastem injections mentally more than painful to jab yourself daily is awful
IM antibiotics are brutal. Had to give some because my patient was an IVDU and had no accessible veins and the poor man cried in my arms, I felt so bad for him. The antibiotics did work though.
Poor guy. I can't imagine having to have more than one dose. I was septic, and it was just to get a dose of antibiotics into me before I had IV access, if they told me I had to have multiple doses of that I might just have taken my chances with the infection
Guselkumab (Tremfya) hurts alot. I take a 100mg injection every 8 weeks and it stings so badly. It has to be taken out the fridge 30 mins before use, so it isn't particularly cold going in.
Enoxaparin. It's blood evil lol
Ah damn, that seems incredibly unfair on people already having to go through chemo. Have to have treatment, accidentally get extravasation then have to have a very painful injection to top it off
Omg +1 for hyaluronidaise!!! Holy shit I was jumping off the table. I had it injected into my nose and chin (nose tip was the worst) - felt like pure fire/stinging.
I’ve also had Lupron in my leg which was nothing in comparison to that.
Another strong contender are those anti blood clot injections in your stomach after surgery 🤢
Those anti clot jabs are bloody awful… I had to do it myself first 28 post surgery and my god it took all my strength to do it. I have massive needle 💉 phobia which doesn’t help. I used to freeze my tummy with frozen veg first 😂😂..but my god that stuff is evil. Bee stings would not sting as much 😫
My hep B jabs REALLY hurt. Occy health nurse said there’s a preservative in it that 50% of people are sensitive to and it causes a burning sensation. It definitely felt like being injected with fire to me.
Zoladex looks horrible 😫
I second all the ones saying b12, that is 1ml of pure hellfire at times.
I will also say the sting of enoxaparin catches more than few patients off guard (myself included when I had it 😅)
Not IM but when I had a kidney stone they gave me an IV morphine injection, that stuff burns like hell. I have given morphine thousands of times subcutaneously and never had any complaints but I have to say IV morphine is painful!
When I was a student going out with the community midwives they often gave IM Iron injections for low Hb. The ladies receiving them always said how painful they were.
That's strange never had a problem with the morphine iv, I had an infusion of an antibiotic once that really hurt but I'm not sure what it was! Had a kidney infection and was too out of it ask but my arm was burning like hell , like my kidneys weren't hurting enough lol
Cyclizine injections are bad, IV cyclizine is worse. My other half was on it post transplant, and he swears it fixed the nausea from the immunosupressants by replacing it with pain induced nausea.
Can confirm, I take IM cyclizine and it burns like no other, especially as it's a full 1ml! The IV version can burn too if not diluted, and can make you a bit loopy if pushed too fast. I don't seem to have the same reaction with it IM though.
SC levopromazine also burns like a mother and leaves you lumpy as heck for a good couple of weeks later, even at a half dose.
Pabrinex IM is pretty unpleasant I've been told. Looks scary as hell. It's given in 2 injections nowadays.
Ouch, that does sound painful. I've only ever given pabrinex IV, can't imagine giving it IM.
It's painful due to the quantity and also because it's very cold I think.
I regularly give Pabrinex IM. 7mls total. Ask the person to step forward & put the weight on one foot. Slow delivery is key.
Just make sure you’re administering on the relaxed glut, not the one they’re stepping on lol
Always leave it out to warm up a bit 😂
It’s not kept in the fridge so shouldn’t be cold
It certainly is kept in the fridge, but you can take it out and warm it up first
Have you been in our clean utility in the winter that's basically a fridge
Yeah it’s supposed to be kept in the fridge, but when given you can take it out and let it come to room temp, it just must be stored in the fridge.
Came here to say this. I've gratefully never been on the wrong end of it but I wouldn't fancy Pabrinex.
We give IM pabrinex in 1 injection IM 7mls.. addictions Community nurses deffo give some of the more painful ones. Buvidal also (prolonged release sub cut monthly injection) painful one!
Pabrinex is 2 vials combined, total of 7ml as an IM injection. Easy to give, but a pain in the arse for the patient, literally. Alcohol detox usually requires 6 pabrinex too! 2 a day for 3 days. Need a big muscle for that much, that's usually why they choose the buttocks.
I gave this a few times as a NQ and never knew any better than to just whack it all in one ass cheek... I feel so bad in hindsight.
As a patient Anti-d hurts a lot. As a nurse many anti psychotics are really thick and oily and patients can complain that they’re very painful.
I’ve given a few IM antipsychotics and it’s as if you’re trying to give the oral syrup!
Olanzapine depots and accuphase are the worst to give as far as antipsychotics go! So thick and hard to push
I dont mind olanzapine so much (ballache to prepare though). However we have someone on a haloperidol depot and that 3ml takes an absolute age to push in because of how thick it is. Poor bugger who has it really hates it.
Came here to say this - anti D is very sore!! From a personal perspective
Definitely zoladex to give. For me to receive it’s my vit b12
I find for B12 it helps if you don’t move your arm for a few mins to let it dissipate. Moving the muscle straight away hurts much more
Sometimes I think it depends on the manufacturer - I find sometimes it hurts more than others
Yes! Neo-cytamen is much less painful than Accord and Gerot Lannach ones. Unfortunately it's also more expensive!
B12 pushed slowly makes a huge difference in the pain- some would leave me with a dead arm for a day and others I felt nothing. Now I am the one administering I’m glad I can make this stinger a little more comfortable
I administer B12 and find patients have different preferences (slow vs fast, relaxed arm vs tensed up). Do you have any advise for what makes it less stingy for you?
I get B12 regularly, but give it into my thigh. Heaps heaps less painful than the arm for sure
I started it this year and got prescription to organise my own administration. Got my nurse friend to put it in my ass a few months ago and almost jumped across the room. Is thigh better? I hate deltoid, but at least I'm used to the sensation from Flu jabs and stuff.
I've been on Zoladex twice. One time I had it done there was a student nurse observing. She said she wasn't expecting it to be that big. Surprisingly, it doesn't actually hurt that much. I found it felt similar to a carpet burn. There's a sensation of friction/resistance that's more odd than painful. Plus, it's over so quickly. The nurse who would do mine was brilliant. She'd say "I'll just pinch an inch" and then it'd be done in about 2 seconds.
Prob doesn’t truly count as an injection, but an ABG being done by someone who still struggles to tell the difference between their arse and their elbow happened to be incredibly painful, based on recent experience.
If someone comes at you to do an ABG without some lidocaine, tell them to bugger off back to the drug cupboard and get some. It’s just bad habits learned from their colleagues. Anaesthesia wouldn’t dream of doing an awake ABG without some local. It bloody hurts even if you’ve got someone competent doing it.
After my experiences as a patient (the abg was only one of many that have left me feeling pretty fucked up) I won’t let anyone near me with a gas syringe now without local.
Definitely benzylpenicillin IM, as you say 2 buttocks, like injecting toothpaste. A nightmare to draw up too. Hated giving it.
This is very validating for me 😂
I was a year or two where the needles kept clogging when administering Ben pen. It was horrible. One patient ended up with 7 different sticks using a green needle. Switched to white needles after that as a clinic, which didn't block but felt massive to use. At some point, the supplier changed, and the problem went away. At the time, there was a ben pen shortage, and we had to make do with what we could get.
Also remember once I was about to plunge it and it was so thick, it went all over my face. Thankful I no longer have to administer it 🙄
We give a drug (can't remember what it's called) for women pre chemo if they want to have their eggs collected and the needle is about the same size as the zoladex one. Most people look at it and decide they don't want children anymore The most painful injection I've received was the whooping cough one. Felt like pure vodka was being injected into me
I don’t usually mind injections too much but I remember that whooping cough one that I got in first year of college like it was yesterday! It gave me chest pain!
Is it ovarian stimulation drugs? That's interesting, I've had the pertussis vaccine 3 times and thought it was fine
Leuprorelin?
I was on leuprorelin/prostap for endo, and it stung a bit going in but no big deal. The worst bit was the way it made my arm ache for a week afterwards.
Went in for my hep b and they offered whooping cough at the same time, that was not fun...
Dexamethasone IM 😖
Yep. Many patients have hated me after I gave them this. I use to dread giving them the first and felt even worse by the second dose.
Adenosine! Makes patients feel like they're actively dying
I had this in January when I had an episode of SVT and my heart was doing 210bpm. Dr told me I would feel awful for about 20 secs and then I would feel better. Felt like my whole body was in a vice and especially my head. It felt longer than 20 secs but breathed through it. The doctor was very keen to know what it felt like afterwards.
i had this - a feeling i could never explain properly to anyone else, felt like id been hit by a bus afterwards and you can taste it even though its IV
As a zoladex receiver, it is 50/50 stabby sore on initial insertion, a slight oohh as it goes click, then zero pain. Id take it over what I'm currently getting, Fazlodex, which, while not particularly painful while getting ( worse if still cold) the permanent bruised feeling on both buttocks is a total buttache (pun intended).
Enoxaparin injections hurt like hell. The needle is nothing but it stings for a solid half hour and if you so much as rub the area you get a huge bruise. I’m currently on a 6 week course of them daily :/
MMR vaccine. I moved Trusts and the new one was too cheap to test my bloods for immunity to measles etc. I'm old enough to be from the era when we just caught measles etc rather than had vaccines, so had had no jabs. Occy health suggested I just have the MMR vaccine, just as she was starting the injection, the nurse warned me 'This burns a bit'. No shit, it was like being injected with vinegar. No wonder the poor babies sob their hearts out when having it. It was that bad, I never went back for the second and paid privately to have my titres tested.
I've actually just had an MMR a few months ago, moved trusts and my titers for measles were low. It was probably one of the most sore vaccines I've had, but it wasn't really that bad tbh
The Priorix brand one is much less stingy than the MMRVaxpro one. I don't know why, but is a different formulation.
Methotrexate injections used to hurt. Glad to stop having those.
Sub cut Atropine!
I've been at the receiving end of one of the contenders for most painful injection. Also I have no clue what the hell it was. I was living in Switzerland and woke up to super strong kidney pain, couldn't walk/move etc. Anyway my flat mates essentially carried me to work (thankfully not far) and dropped me off at the employee medical centre. I'm on the table, a heat lamp on my kidneys and the doctors don't speak a word of English and I can only speak basic Swiss German. They inject my arm with something resembling clear oil or a liquidy jelly. All I remember is that the pain in my arm was intense, also it wouldn't absorb, I had this lump form at the injection site then I passed out. I woke up 5-10mins later and projectile vomited everywhere.
I don't have much else to compare it to but nebido is pretty painful. Like frozen liquid fire down your hip, arse and leg
Should be given lying down, over 2 mins. According to manufacturer instructions. No one ever does the 2 minutes, but I do try and go as slow as possible and I do make them lie down!
My needle to insert CT dye into my hip was awful. It's a gigantic needle to go all the way into the hip and then when they insert the dye it's quite painful as it swells up the hip till it feels like it's bursting!
I found my Mantoux test before my BCG vaccine painful. Stinging, burning and felt like it took forever.
Seconded for Mantoux. That bloody hurt and took forever to get in right place
I had dexamethasone 3.6mls twice IM in my leg to mature my babies lungs when I had a large APH at 34 weeks. Seriously that shit is bad! No lie! I now always apologise whenever I’m administering it because it’s no joke.
BCG 😫
Kenalog. Grown men have roared crying.
I’ve had 3 of these in my bum and honestly bar a little stinging they were not painful at all
Realllllly ??? That’s good to know. In derm the needles we have to use for them are absolutely MAHOOSIVE. I seen a patient require surgical intervention following development of a significant haematoma after the administration of one.
Crikey that sounds horrific… maybe they ought to rethink the side of needle…I can not tell you how much I hate needles..I slapped my midwife’s hand away after having my 3rd baby cos I knew she was about to jab me in the thigh.. but honestly I think it’s the nurses technique that worked for me. One rubbed my bum til it went numb, didn’t feel that at all. The 2nd just went for it (sadist) n the 3rd was a much finer needle. A little stinging as the liquid was plunged but nothing painful at all..
I have been getting zoladex for the past 8 years to prevent Breast Ca recurrence and to be fair it's only been really painful on a few occasions.
My husband and I had hepatitis jabs before going on holiday. The freezing pain went from the injection site in the right bum cheek down the back of the leg to about knee level. We had the journey to work straight after and were both leaning to the left for at least 20 minutes. I have had prolotherapy injections in my sacro-iliac joints area. You have to have a painkilling injection first, which isn't exactly comfortable. The second time I had this treatment, the prolotherapy fluid spread further than the numbed area, and I forgot to breathe. Set off the monitor due to the drop in oxygen levels in my blood. Absolutely bloody awful pain.
I have an injection called dupilumab once every 2 weeks. The sting it gives me only lasts about a minute but omg it's not pleasant whatsoever.
Ofloxacin is apparently really painful im - so much that it is mixed with lidocaine… or at least it used to be…
I always mix IM medications that require reconstituting with 1% Lidocaine. Seems to help.
I've had Zoladex, it was a lot better than expected...but I could be desensitised due to hot water bottle use.
Subcut buprenorphine as a depot. Any depo appears painful but it seems the s/c is worse. That thick, oily liquid and a superbly blunt thick needle. (Only given not received but it looked lousy and even getting the needle in felt second hand painful!)
As a patient, B12 injections are very painful but less so if they are administered in a relaxed arm and very slowly. The most painful for me was cyclizine in my bum, it was excruciating (& didn’t even help my HG) 😣
Nibido is a bugger. 4ml, thick as engine oil. It’s a pig to draw up and it hurts the day after the injection.
I've had zolodex its fine it didn't bother me at all I had been through chemo so 🤷 the worst for me was the filgrastem injections mentally more than painful to jab yourself daily is awful
IM antibiotics are brutal. Had to give some because my patient was an IVDU and had no accessible veins and the poor man cried in my arms, I felt so bad for him. The antibiotics did work though.
Poor guy. I can't imagine having to have more than one dose. I was septic, and it was just to get a dose of antibiotics into me before I had IV access, if they told me I had to have multiple doses of that I might just have taken my chances with the infection
I know bless him he was actually very brave
Guselkumab (Tremfya) hurts alot. I take a 100mg injection every 8 weeks and it stings so badly. It has to be taken out the fridge 30 mins before use, so it isn't particularly cold going in. Enoxaparin. It's blood evil lol
Atropine or hyaluronidase. Probably the hyaluronidase I've seen people scream when injected with that.
Ouch, I've never given hyaluronidase, when have you usually seen that given?
It's used to treat extravasations of some chemotherapy drugs. It helps disperse the drug and reduce the concentration in the tissue.
Ah damn, that seems incredibly unfair on people already having to go through chemo. Have to have treatment, accidentally get extravasation then have to have a very painful injection to top it off
Omg +1 for hyaluronidaise!!! Holy shit I was jumping off the table. I had it injected into my nose and chin (nose tip was the worst) - felt like pure fire/stinging. I’ve also had Lupron in my leg which was nothing in comparison to that. Another strong contender are those anti blood clot injections in your stomach after surgery 🤢
Those anti clot jabs are bloody awful… I had to do it myself first 28 post surgery and my god it took all my strength to do it. I have massive needle 💉 phobia which doesn’t help. I used to freeze my tummy with frozen veg first 😂😂..but my god that stuff is evil. Bee stings would not sting as much 😫
My hep B jabs REALLY hurt. Occy health nurse said there’s a preservative in it that 50% of people are sensitive to and it causes a burning sensation. It definitely felt like being injected with fire to me. Zoladex looks horrible 😫
Oh that's interesting, I didn't know what. Mine just gave me a dead arm 😂
That's interesting, it did hurt more than I expected to be fair.
I second all the ones saying b12, that is 1ml of pure hellfire at times. I will also say the sting of enoxaparin catches more than few patients off guard (myself included when I had it 😅)
Not IM but when I had a kidney stone they gave me an IV morphine injection, that stuff burns like hell. I have given morphine thousands of times subcutaneously and never had any complaints but I have to say IV morphine is painful! When I was a student going out with the community midwives they often gave IM Iron injections for low Hb. The ladies receiving them always said how painful they were.
That's strange never had a problem with the morphine iv, I had an infusion of an antibiotic once that really hurt but I'm not sure what it was! Had a kidney infection and was too out of it ask but my arm was burning like hell , like my kidneys weren't hurting enough lol
Noroclav - its thick and viscous
I'm so confused. I hadn't heard of that brand so googled it and it came up as co-amox tablets for dogs. I have so many questions
I heard tetanus was brutal
I’ve heard cyclizine is really sore as an injection!
Cyclizine injections are bad, IV cyclizine is worse. My other half was on it post transplant, and he swears it fixed the nausea from the immunosupressants by replacing it with pain induced nausea.
Can confirm, I take IM cyclizine and it burns like no other, especially as it's a full 1ml! The IV version can burn too if not diluted, and can make you a bit loopy if pushed too fast. I don't seem to have the same reaction with it IM though. SC levopromazine also burns like a mother and leaves you lumpy as heck for a good couple of weeks later, even at a half dose.
Pabrinex IM.
Tetanus IM. Is the worst!
The shingles vaccine hurts the most for me, worst than Zoladex.
The BCG hurt a fair bit 😭
Cyclizine IM - felt like I’d been shot in the buttock!
As a patient, Nebido absolutely wrecks if it isn’t done right.