Biologic Therapies: How to Inject Safely and Avoid Infections

When you’re prescribed a biologic therapy, it’s not just about taking a drug-it’s about learning how to inject it correctly, every single time. These medications, made from living cells, are powerful. They can calm down autoimmune diseases like rheumatoid arthritis, psoriasis, or Crohn’s disease. But if you don’t inject them right, you’re not just wasting money-you’re putting yourself at risk for serious infections.

Why Injection Training Isn’t Just a Formality

Most patients get their first injection training in a doctor’s office. A nurse or pharmacist shows them how to use the pen device, maybe lets them practice on a dummy, and then sends them home with a box of pens. Sounds simple, right? But here’s the problem: most training sessions last less than 30 minutes. That’s not enough time to learn, practice, and feel confident.

A 2022 study found that 91% of patients say they received training-but only 27% got the full package: tell, show, and do. That means they heard instructions, watched a demo, and then actually practiced under supervision. The rest? They got a quick demo and were told, “You’ve got this.”

That’s dangerous. Nearly one in three patients report feeling unsure about their technique within the first six months. And when you’re unsure, you make mistakes. You might not clean the skin well enough. You might inject too fast. You might reuse a needle. All of that raises your risk of infection.

How Infections Happen (And How to Stop Them)

Biologics suppress your immune system. That’s how they work-they quiet down the overactive immune response causing your disease. But that also means your body can’t fight off germs as easily. A small skin infection from a dirty needle or poor site prep can turn into something serious, fast.

The CDC says improper injection technique contributes to 12.7% of all outpatient skin infections linked to injectable meds. That’s not a small number. Most of these infections start at the injection site. Signs to watch for:

• Redness bigger than 2 cm around the injection spot
• Warmth or swelling that gets worse, not better
• Pain that feels deeper than a pinch
• Fever over 100.4°F (38°C)
• Pus or fluid draining from the site

If you see any of these, don’t wait. Call your doctor. Don’t try to “wait it out.”

The biggest cause? Poor skin prep. You need to clean the area with alcohol and let it dry completely. Don’t wipe it off with your shirt or your sleeve. Don’t touch the spot after cleaning. And never reuse a needle-even if it looks fine. Needles dull after one use, and that increases tissue damage and infection risk.

What Good Training Actually Looks Like

Good training isn’t a one-time event. It’s a process. Here’s what real, effective training includes:

1. Tell: Clear, simple instructions. No jargon. “Press here until you hear a click” is better than “Activate the auto-injector mechanism.”
2. Show: A live demo with a training device-not just a video. You need to see the motion, the timing, the pressure.
3. Do: You get to try it. With supervision. With feedback. If you fumble, they correct you. Right then.

And here’s the kicker: you need to do this more than once. A 2023 study found that patients who had three or more supervised practice sessions kept 94% of their technique skills after six months. Those with only one session? Only 52% retained it.

Also, don’t skip the “teach-back” method. That’s when your provider asks you to show them how you’d do it yourself. If you can’t explain or demonstrate it, you’re not ready to go home.

The Hidden Problem: Anxiety and Rituals

Most training focuses on the mechanics. But the biggest reason people stop taking biologics isn’t side effects-it’s fear.

One patient on Reddit said: “They showed me once. I did it once. Then I had six months of pens and no help.” That’s common. And it’s terrifying. Needle anxiety is real. It causes shaking, rushed injections, skipped steps.

The solution? Rituals.

Successful patients don’t just inject-they create a routine. Same time. Same spot. Same music. Same deep breath before the click. One study found that patients who built a personal ritual had 53% fewer anxiety-related errors and were 41% more likely to stick with treatment.

Your ritual doesn’t have to be fancy. Wash your hands. Put on your favorite playlist. Sit in your favorite chair. Take three slow breaths. Say out loud: “I’ve got this.” That’s it. That small pause makes your brain switch from panic mode to calm mode.

Where Training Falls Short-and What to Ask For

Here’s the truth: most healthcare providers weren’t trained to teach injections. They learned how to give them, but not how to teach them. A 2022 survey found that 94% of providers admit they rely on trial and error.

So you need to be your own advocate.

Ask for:

• A training device to take home (they’re free and contain no medicine)
• A video link to a manufacturer’s official tutorial (Adbry, Enbrel, Humira all have them)
• A follow-up call or video check-in after your first injection
• Access to a pharmacist who specializes in biologics-many pharmacies now offer this

Also, make sure you’re training with the actual medication you’ll be using. One study found that 42% of training sessions were done without the real device. That’s like learning to drive with a toy car.

Injection Site Rules You Can’t Ignore

Where you inject matters. Rotating sites prevents tissue damage and reduces infection risk. Here’s what to do:

• Use your abdomen (2 inches away from your belly button), thighs, or upper arms
• Keep at least 1 inch between each new injection and the last one
• Don’t inject into scars, bruises, or areas with rashes
• Keep a log-write down where you injected each time. Apps like MyBiologics or Humira’s tracker help

And always have a sharps container. Never toss needles in the trash. Many pharmacies give them out for free. Ask.

What’s Changing in 2026

The FDA just updated its guidance for biologic training in early 2025. They’re now requiring manufacturers to provide standardized, accessible training materials-including video, step-by-step guides, and virtual coaching.

Some companies are already ahead. Adbry’s portal lets you watch videos, practice with a virtual trainer, and even get real-time feedback from a pharmacist via video call. That’s the future.

But until everyone catches up, you can’t wait for perfection. You need to demand better training now.

What to Do If You’re Already Struggling

If you’ve been injecting for a while and feel unsure, it’s not too late.

1. Call your pharmacy. Ask if they have a biologic nurse or pharmacist who can do a refresher.

2. Watch the official video for your drug-don’t rely on YouTube clips.

3. Practice with a training pen every day for 5 minutes. Muscle memory matters.

4. Ask for a follow-up appointment. Say: “I want to make sure I’m doing this right. Can we review?”

And if you’ve had a reaction at the injection site-redness, pain, swelling-don’t assume it’s normal. Get it checked. Infections from biologics don’t always look like big boils. Sometimes they’re just a small warm spot that won’t go away.

You’re Not Alone

Thousands of people are learning to inject these drugs every day. Some nail it on the first try. Others need months. That’s okay.

The goal isn’t perfection. It’s safety. And safety comes from preparation, practice, and knowing when to ask for help.

Don’t let a 30-minute training session be the only thing standing between you and a serious infection. Push for more. Demand better. Your health depends on it.