Is there any advantage in administering injectable medroxyprogesterone (Depo-Provera [DMPA]) in the deltoid as opposed to the gluteus?—KATHY INGALLINERA, FNP, Sitka, Alaska

The likely rationale for deltoid injection is to spare the client having to expose her rear end, but there’s no discernable medical reason. No studies have suggested any advantage to using the deltoid over the gluteal muscle for administering DMPA. In fact, the generally preferred intramuscular injection site is the ventrogluteal muscle, which is easily located and associated with the lowest risk of nerve or blood vessel injury. The deltoid is also considered by most to be a more painful injection site than the gluteus. Regardless of the chosen administration site, do not massage the muscle after the injection is administered. Another option to consider is subcutaneous DMPA, which can be injected in the anterior thigh or abdomen. The efficacy remains the same, though some patients have reported skin deformations.—Lisa Stern, APRN (140-2)

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