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doi: 10.1056/NEJMoa2107519 Karagiannis T, Avgerinos I, Liakos A, et al

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Step-by-step injection guide Preparation: Wash hands thoroughly with soap and water Gather supplies: reconstituted retatrutide, insulin syringe, alcohol swabs Check solution is clear (discard if cloudy or contains particles) Allow solution to reach room temperature if refrigerated Drawing the dose: Clean vial top with alcohol swab, let dry Draw calculated volume of air into syringe Insert needle into vial, inject air Invert vial and withdraw exact dose Remove air bubbles by tapping syringe gently Confirm correct volume Injection: Choose injection site (abdomen, thigh, or upper arm) Clean site with alcohol swab, let dry completely Pinch skin to create fold (optional but recommended) Insert needle at 90 angle (or 45 if very lean) Depress plunger slowly and steadily Wait 5-10 seconds before withdrawing needle Apply gentle pressure with gauze if needed Dispose of needle in sharps container Injection site rotation Rotate weekly to prevent: Lipohypertrophy (fatty lumps) Injection site reactions Inconsistent absorption Rotation pattern example: Spacing: Each injection should be at least 1 inch from previous sites

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