In Australia the only commercial grade Injectable TRT medications come in 1ml pre filled syringes (Bayer Primoteston or Sustanon). This needs to be transferred into a sterile vial so we can accurately administer smaller, more frequent doses.
Our doctors prescribe small doses generally administered 2-3 times per week, which enables patients to have more stable serum testosterone levels compared to 1 large injection every 2 weeks, and results in better treatment outcomes.
What You'll Receive:
6 x 1ml Primoteston (Testosterone Enanthate) Pre-Filled Syringes or 6 x 1ml Sustanon Ampoules
2 x 5ml Empty Sterile Vials
Your Injection Kit:
28 x 1ml Syringes
28 x 25g 1” Needles (Injections)
28 x 21g 1” Needles (Drawing)
28 x Alcohol Swabs
Storage:
Keep in a dark cool area with no direct sunlight
Vials should be replaced each resupply
Preparing Your Treatment
1. Prepare Vial
Please do not to remove the cap entirely, just peel back the lip on the vial.
Removing the aluminium cap completely will detach it from the crimping, compromising the seal.
2. Clean the rubber top with an alcohol swab
3. Set aside
2a. Prepare Medication (Primoteston)
For patients prescribed Primoteston, open the Primoteston box
Put the 3 plastic packets on a clean, sanitised table
Assemble the syringes with the large needles that come in each pack, as instructed on the Primoteston box
Set the three syringes aside, with the needle caps still on
Do not discard your medication packaging as it has your prescription details on it
2b. Prepare Medication (Sustanon)
For patients prescribed Sustanon, snap the top off the ampoule as per instructions included, assemble a 1ml needle with a 21G Drawing needle (or an 18G blunt filter needle), and set aside
Do not discard your medication packaging as it has your prescription details on it
3. Transfer to vial
Place the vial on the table upright
Remove the plastic Primoteston needle cap, exposing the needle
Insert needle into the rubber membrane of the vial
Push down on plunger to transfer the oil into the vial
Pull back on plunger to draw in 1ml of air (this will ensure the vial is not pressurised)
Repeat steps 2-5 with the remaining two Primoteston syringes
For Sustanon patients, draw 1ml into the syringe, and inject into the vial with the above instructions. (If you have used an 18G blunt filter needle to draw up the medication then you should change this over to a 21G needle to pierce the rubber membrane on the vial)
4. Preparing your dose
Set aside: 1 x 1ml low dead space syringe, 1 x 25G needle, 1 x 21G needle. (For Sustanon patients you only need to set aside the 25G needle as you already have the 21G needle attached to a 1ml syringe)
Remove the packaging of the above items
Connect the 21G needle to the low dead space syringe
Hold the vial in one hand, and the assembled syringe in the other hand
Insert the needle into the vial
Rotate the vial, so that the rubber top is facing down and needle facing up inside the vial.
Pull down on the plunger to the prescribed dose on the syringe
Ensure there is no air in the syringe
Turn the vial upright again and withdraw the needle
Pull the plunger back to pull in any remaining oil from the needle into syringe. This will help to significantly reduce medication wastage in the long run. (It is OK if you pull in some air too, as this will be purged before injection)
Remove the 21G needle and put on the 25G needle
Aim the needle to the sky and slowly push out any remaining air until the medication is visible at the tip of the needle. This is called ‘priming’ the needle.
Once primed, double check that the plunger mark is at your prescribed dose, as this is the true dose you will receive from the injection.
If there is excess medication in the syringe then you can decant the excess into your sterile vial. If there is not enough then you should draw enough to meet your prescribed dose.
5. Injecting your dose
NOTE: This medication is only to be injected intramuscularly, not subcutaneously.
Select your injection site (quadriceps or glutes only)
Clean it with an alcohol wipe and allow to air dry
Take a deep breath and relax the muscle
Hold the syringe by the barrel like a pen
Insert needle at 90 degrees to the skin in a swift motion
For quadriceps injections, ensure the needle is inserted to at least three quarters depth to ensure it reaches the muscle. For glute injections the needle should be inserted to full depth.
Once the needle is inserted, keep the syringe steady with one hand to limit needle movement. With your other hand, pull back the plunger gently to ensure the needle is not in a vein. If no blood is drawn into the syringe then you are safe to skip to step 9. You do not need to pull back far or firmly, as that can cause irritation or swelling at the injection site.
In the unlikely scenario that blood is drawn into the syringe, you should withdraw the needle and apply firm pressure to the injection site for 1 minute to stop any potential bleeding and minimise bruising. You may then attach a new needle and use a different injection site.
Slowly press down on plunger to inject the medication
Hold the needle in place for 10 seconds after injection is complete to ensure optimal absorption of medication.
Withdraw the needle as swiftly as you inserted it.
Unscrew the needle from the syringe and dispose of the needle in your sharps container. The plastic syringe can be put into your domestic bin. This will ensure that your sharps container lasts around 5 times longer than if you had kept the needle attached to the syringe. (Never put needles in a domestic bin, even if they have been recapped).
A video on TRT injections can be found below or via this URL: https://www.youtube.com/watch?v=KsYwXP8Q58E
For patients who travel regularly:
Please do not transfer all of the Primoteston into the vial when you first receive your medication, as you can only take medication in its original packaging with prescription label through customs. Bring as much as is needed for your overseas trip in its original pre-filled syringes, which you can transfer into an empty vial when you reach your destination. Dispose of the vial responsibly before returning to Australia as you cannot bring the vial back into the country.
Letters for overseas travel with your medication are available on request.
If you require help:
If you require assistance with your injections, please book a nurse consultation here: https://calendly.com/daniel-m-hormn/30min