There are loading doses: the first is 4 times a normal dose, the second is 2 times. The epipens are startling. I would request the syringe if you can, you can control the dosing rate. Humira really burns, so we ice up my son for about 15 min beforehand, I also take the syringe out of the fridge 15 min. beforehand, so it's not as cold and not as painful. My son chooses his front thighs and we rotate between them. I've heard around the belly is less painful, but he won't try it. If you opt for lidocaine, you have to mix it just before injection, or inject it first, a few minutes before Humira, we haven't tried that, but did discuss it. Humira has a great support site, nurses are on-call and one will come to your home to help you through the first injection. We've had no side effects, but occasional blistering or rashing at the injection site.
Best of luck and I hope it works for your daughter!