How to Make Liquid Medicine for an Injection

Sometimes you need to make liquid medicine from powder to give your child an injection (shot). It is important to keep the medicine sterile (germ free) and mix the correct amount of liquid with the powder. Always follow the instructions given by your care team.

Clean your work area and gather supplies

• Wash your hands with soap and water for 20 seconds and dry with a paper towel or a clean cloth towel. Or use an alcohol-based hand sanitizer.
• Use an alcohol prep pad or disinfecting wipe to clean a flat surface large enough for the items you need.   
• Throw away the alcohol pad.
• Gather your supplies: 
  • Vial with powder medicine
  • Vial of liquid
  • 1 empty syringe
  • 1 blunt needle
  • Sharps container

Note: if you will be giving the shot right away, make sure you have any additional supplies needed.

Prepare your supplies

• Check the medicine label and the prescription label. Make sure they match and that all the information is correct.  
• Take the plastic caps off the vials of powder medicine and liquid. Using your thumb, flip the tops up and off. You will see the rubber stoppers – do not touch the stoppers.
• Clean both stoppers with an alcohol pad for 7 seconds. Let them air dry. Do not blow air on them or fan them. Put the vials aside while you get the other items ready.
• Open the packages with all three of the needles and syringes. Leave them in the package until you are ready to use them.
• Take the larger syringe out of the package and put a blunt red needle on it. Carefully pull the cap straight off the needle.

Fill the syringe with liquid (sterile water or saline)

• Be sure you know how much liquid (in mL) you need to add to the powder.
• Hold the larger syringe in 1 hand. Pull back on the plunger of the syringe to fill it with air. The amount of air pulled into the syringe should be the same as the amount of liquid you will need.  
• Put the vial of liquid on a flat surface. Insert the needle straight through the rubber stopper.
• Push the syringe plunger down and push air into the vial. Keep your thumb on the plunger so air does not come back into the syringe. This makes it easier to get the liquid into the syringe.
• Hold the vial of liquid. Keeping the needle in the vial, turn the vial upside down. 
• Withdraw liquid from the vial by pulling back on the syringe plunger until you have the correct amount of liquid. The liquid will flow into the syringe. Keep the tip of the needle inside the vial below the level of the liquid. You may have to move the syringe down to keep the needle in the liquid.
• When the correct amount of liquid is in the syringe, pull the needle completely out of the vial.
• If the needle touches anything other than the cleaned stopper, discard the needle and start over.

Add liquid to the powdered medicine 

• Put the vial of powder on a flat surface. 
• Insert the needle of the syringe through the rubber stopper of the vial with the powder.
• Push the liquid into the powdered medicine. If you are putting liquid into more than 1 vial, do the same thing with the second vial.
• Remove the needle from the vial with powdered medicine. 
• Throw away the needle in the sharp's container.

Mix the medicine

• Gently roll the vial between your palms to mix the medicine well. Roll until all the medicine is dissolved. Do not shake the vial. This could damage the medication. 
• Wipe the rubber stopper with an alcohol prep pad for 7 seconds. Let the stopper air dry. Do not blow air on it.
• Write the date and time that you mixed the medicine on the label of the vial. Medicine can only be used for a limited amount of time after mixing it. It is important to write down when it was mixed.   
• If you are giving the medicine right away, follow your care team’s instructions for how to withdraw the medicine and give the shot.
• If you are not giving the medicine right away, store the medicine as instructed.

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