diff --git a/messages/de.json b/messages/de.json
index 0a306575b..6279c75b8 100644
--- a/messages/de.json
+++ b/messages/de.json
@@ -1360,6 +1360,7 @@
     "logInjectionSiteSkip": "Überspringen",
     "logInjectionSiteConfirm": "Stelle speichern",
     "logInjectionSiteNoneAvailable": "Keine Injektionsstelle verfügbar — alle Stellen sind in deinen Einstellungen ausgeschlossen.",
+    "logInjectionSiteSaveFailed": "Injektionsstelle konnte nicht gespeichert werden. Bitte versuche es erneut.",
     "trackInjectionSitesToggle": "Injektionsstellen erfassen",
     "trackInjectionSitesHint": "Nach einer eingenommenen Dosis nach der verwendeten Stelle fragen und die nächste Rotation vorschlagen.",
     "allowedSitesLabel": "Erlaubte Stellen",
diff --git a/messages/en.json b/messages/en.json
index d185f1009..7bf8cd516 100644
--- a/messages/en.json
+++ b/messages/en.json
@@ -1360,6 +1360,7 @@
     "logInjectionSiteSkip": "Skip",
     "logInjectionSiteConfirm": "Save site",
     "logInjectionSiteNoneAvailable": "No injection site is available — every site is excluded in your settings.",
+    "logInjectionSiteSaveFailed": "Could not save the injection site. Please try again.",
     "trackInjectionSitesToggle": "Track injection sites",
     "trackInjectionSitesHint": "After a dose is taken, ask which site was used and suggest the next rotation.",
     "allowedSitesLabel": "Allowed sites",
diff --git a/messages/es.json b/messages/es.json
index 0249166c8..8e67fd515 100644
--- a/messages/es.json
+++ b/messages/es.json
@@ -1360,6 +1360,7 @@
     "logInjectionSiteSkip": "Omitir",
     "logInjectionSiteConfirm": "Guardar sitio",
     "logInjectionSiteNoneAvailable": "No hay ningún sitio de inyección disponible: todos los sitios están excluidos en tu configuración.",
+    "logInjectionSiteSaveFailed": "No se pudo guardar el sitio de inyección. Inténtalo de nuevo.",
     "trackInjectionSitesToggle": "Registrar sitios de inyección",
     "trackInjectionSitesHint": "Tras administrar una dosis, pregunta qué sitio se usó y sugiere la siguiente rotación.",
     "allowedSitesLabel": "Sitios permitidos",
diff --git a/messages/fr.json b/messages/fr.json
index 2b5898a33..387eb3146 100644
--- a/messages/fr.json
+++ b/messages/fr.json
@@ -1360,6 +1360,7 @@
     "logInjectionSiteSkip": "Ignorer",
     "logInjectionSiteConfirm": "Enregistrer le site",
     "logInjectionSiteNoneAvailable": "Aucun site d'injection disponible — tous les sites sont exclus dans vos réglages.",
+    "logInjectionSiteSaveFailed": "Impossible d’enregistrer le site d’injection. Veuillez réessayer.",
     "trackInjectionSitesToggle": "Suivre les sites d'injection",
     "trackInjectionSitesHint": "Après la prise d'une dose, demander quel site a été utilisé et suggérer la prochaine rotation.",
     "allowedSitesLabel": "Sites autorisés",
diff --git a/messages/it.json b/messages/it.json
index 02ac12673..bb59bbeba 100644
--- a/messages/it.json
+++ b/messages/it.json
@@ -1360,6 +1360,7 @@
     "logInjectionSiteSkip": "Salta",
     "logInjectionSiteConfirm": "Salva il sito",
     "logInjectionSiteNoneAvailable": "Nessun sito di iniezione disponibile: tutti i siti sono esclusi nelle tue impostazioni.",
+    "logInjectionSiteSaveFailed": "Impossibile salvare il sito di iniezione. Riprova.",
     "trackInjectionSitesToggle": "Registra i siti di iniezione",
     "trackInjectionSitesHint": "Dopo l'assunzione di una dose, chiedi quale sito è stato usato e suggerisci la rotazione successiva.",
     "allowedSitesLabel": "Siti consentiti",
diff --git a/messages/pl.json b/messages/pl.json
index fb5f3e33a..3cd2f31d2 100644
--- a/messages/pl.json
+++ b/messages/pl.json
@@ -1360,6 +1360,7 @@
     "logInjectionSiteSkip": "Pomiń",
     "logInjectionSiteConfirm": "Zapisz miejsce",
     "logInjectionSiteNoneAvailable": "Brak dostępnego miejsca iniekcji — wszystkie miejsca są wykluczone w Twoich ustawieniach.",
+    "logInjectionSiteSaveFailed": "Nie udało się zapisać miejsca iniekcji. Spróbuj ponownie.",
     "trackInjectionSitesToggle": "Rejestruj miejsca iniekcji",
     "trackInjectionSitesHint": "Po przyjęciu dawki zapytaj, którego miejsca użyto, i zaproponuj kolejną rotację.",
     "allowedSitesLabel": "Dozwolone miejsca",
diff --git a/src/components/medications/__tests__/log-injection-site-dialog.test.tsx b/src/components/medications/__tests__/log-injection-site-dialog.test.tsx
new file mode 100644
index 000000000..2dd543e20
--- /dev/null
+++ b/src/components/medications/__tests__/log-injection-site-dialog.test.tsx
@@ -0,0 +1,101 @@
+/**
+ * v1.11.5 — `<LogInjectionSiteDialog>` controlled-submit coverage.
+ *
+ * The dialog used to dismiss optimistically the instant Confirm fired —
+ * before the parent's PATCH resolved and with no pending state. This suite
+ * pins the controlled-dialog contract:
+ *
+ *   1. The dialog SSRs its skip / confirm footer (Confirm disabled until a
+ *      site is picked).
+ *   2. The confirm handler awaits the (possibly async) `onConfirm`, holding
+ *      a `submitting` state, and `onOpenChange` refuses to close while a
+ *      request is in flight.
+ *
+ * Project convention is SSR-only component tests (`renderToStaticMarkup`,
+ * no `@testing-library/react`) plus source-string structural assertions for
+ * the interactive plumbing an SSR mount can't exercise.
+ */
+import { describe, expect, it, vi } from "vitest";
+import { readFileSync } from "node:fs";
+import { resolve } from "node:path";
+import { renderToStaticMarkup } from "react-dom/server";
+
+import { I18nProvider } from "@/lib/i18n/context";
+
+// The Radix Dialog portals at runtime, so its body never materialises in
+// static markup. Collapse the primitives to plain wrappers (same trick as
+// the ResearchModeAcknowledgmentDialog suite) so the footer is reachable.
+vi.mock("@/components/ui/dialog", () => {
+  const Pass = ({ children }: { children?: React.ReactNode }) => (
+    <div>{children}</div>
+  );
+  return {
+    Dialog: ({ open, children }: { open: boolean; children: React.ReactNode }) =>
+      open ? <div data-slot="mock-dialog">{children}</div> : null,
+    DialogContent: Pass,
+    DialogDescription: Pass,
+    DialogFooter: Pass,
+    DialogHeader: Pass,
+    DialogTitle: Pass,
+  };
+});
+
+const { LogInjectionSiteDialog } = await import("../log-injection-site-dialog");
+
+function render(node: React.ReactNode, locale: "en" | "de" = "en"): string {
+  return renderToStaticMarkup(
+    <I18nProvider initialLocale={locale}>{node}</I18nProvider>,
+  );
+}
+
+const src = readFileSync(
+  resolve(__dirname, "../log-injection-site-dialog.tsx"),
+  "utf8",
+);
+
+describe("<LogInjectionSiteDialog>", () => {
+  it("renders the skip / confirm footer with Confirm gated on a selection", () => {
+    const html = render(
+      <LogInjectionSiteDialog
+        open
+        medicationName="Mounjaro"
+        allowedInjectionSites={[]}
+        globalExcludedInjectionSites={[]}
+        history={[]}
+        onConfirm={vi.fn()}
+        onSkip={vi.fn()}
+      />,
+    );
+    expect(html).toContain("Save site");
+    expect(html).toContain("Skip");
+    // Confirm starts disabled (no site selected yet).
+    expect(html).toMatch(/Save site/);
+    expect(html).toContain("disabled");
+  });
+
+  it("awaits onConfirm behind a submitting guard and re-enables in finally", () => {
+    expect(src).toContain("const [submitting, setSubmitting] = useState(false)");
+    expect(src).toMatch(
+      /async function handleConfirm\(\) \{[\s\S]*setSubmitting\(true\)[\s\S]*await onConfirm\(selected\)[\s\S]*finally \{[\s\S]*setSubmitting\(false\)/,
+    );
+  });
+
+  it("refuses to close the dialog while a request is in flight", () => {
+    expect(src).toMatch(
+      /onOpenChange=\{\(next\) => \{[\s\S]*if \(submitting\) return;[\s\S]*if \(!next\) onSkip\(\)/,
+    );
+  });
+
+  it("disables both footer buttons and shows a spinner while submitting", () => {
+    expect(src).toMatch(/onClick=\{onSkip\} disabled=\{submitting\}/);
+    expect(src).toContain("selected === null || submitting");
+    expect(src).toContain("aria-busy={submitting || undefined}");
+    expect(src).toContain("Loader2");
+  });
+
+  it("accepts an async onConfirm in its prop contract", () => {
+    expect(src).toContain(
+      "onConfirm: (site: InjectionSiteKey) => void | Promise<void>",
+    );
+  });
+});
diff --git a/src/components/medications/glp1-medication-card.tsx b/src/components/medications/glp1-medication-card.tsx
index a687d037c..277362e4f 100644
--- a/src/components/medications/glp1-medication-card.tsx
+++ b/src/components/medications/glp1-medication-card.tsx
@@ -280,18 +280,21 @@ export function Glp1MedicationCard({
 
   async function confirmInjectionSite(site: InjectionSiteKey) {
     const intakeId = siteIntakeId;
-    setSiteIntakeId(null);
     if (!intakeId) return;
+    // v1.11.5 — keep the dialog open until the PATCH resolves. On failure
+    // surface a toast and re-throw so the dialog stays mounted with the
+    // chosen site instead of dismissing as though the site had been saved.
     const res = await fetch("/api/medications/intake", {
       method: "POST",
       headers: { "Content-Type": "application/json" },
       body: JSON.stringify({ intakeId, status: "taken", injectionSite: site }),
     });
-    if (res.ok) {
-      await invalidateKeys(queryClient, medicationDependentKeys);
-    } else {
-      toast.error(t("medications.logInjectionSiteNoneAvailable"));
+    if (!res.ok) {
+      toast.error(t("medications.logInjectionSiteSaveFailed"));
+      throw new Error("injection-site PATCH failed");
     }
+    await invalidateKeys(queryClient, medicationDependentKeys);
+    setSiteIntakeId(null);
   }
 
   const schedule = medication.schedules[0] ?? null;
diff --git a/src/components/medications/log-injection-site-dialog.tsx b/src/components/medications/log-injection-site-dialog.tsx
index 748b78e3f..2b8ee7753 100644
--- a/src/components/medications/log-injection-site-dialog.tsx
+++ b/src/components/medications/log-injection-site-dialog.tsx
@@ -2,6 +2,8 @@
 
 import { useState } from "react";
 
+import { Loader2 } from "lucide-react";
+
 import {
   Dialog,
   DialogContent,
@@ -38,8 +40,13 @@ interface LogInjectionSiteDialogProps {
   globalExcludedInjectionSites: ReadonlyArray<InjectionSiteKey>;
   /** Recent rotation history (most recent first) for the dashed-ring hint. */
   history: ReadonlyArray<InjectionSiteKey>;
-  /** Submit the chosen site (the parent PATCHes it onto the intake). */
-  onConfirm: (site: InjectionSiteKey) => void;
+  /**
+   * Submit the chosen site (the parent PATCHes it onto the intake). The
+   * handler may be async; the dialog stays open with a pending state until
+   * it resolves and rejects (throws) on failure so the dialog can keep the
+   * user's selection rather than dismissing optimistically.
+   */
+  onConfirm: (site: InjectionSiteKey) => void | Promise<void>;
   /** Dismiss without recording a site (the dose stays taken). */
   onSkip: () => void;
 }
@@ -55,16 +62,35 @@ export function LogInjectionSiteDialog({
 }: LogInjectionSiteDialogProps) {
   const { t } = useTranslations();
   const [selected, setSelected] = useState<InjectionSiteKey | null>(null);
+  // v1.11.5 — the dialog used to dismiss optimistically the instant the
+  // confirm fired, before the PATCH resolved and with no pending state.
+  // It now stays open and disabled until the parent's handler settles; the
+  // parent throws on failure so a rejected PATCH keeps the dialog (and the
+  // chosen site) in place.
+  const [submitting, setSubmitting] = useState(false);
 
   const allowed = effectiveAllowedSites(
     allowedInjectionSites,
     globalExcludedInjectionSites,
   );
 
+  async function handleConfirm() {
+    if (selected === null || submitting) return;
+    setSubmitting(true);
+    try {
+      await onConfirm(selected);
+    } finally {
+      setSubmitting(false);
+    }
+  }
+
   return (
     <Dialog
       open={open}
       onOpenChange={(next) => {
+        // Hold the dialog while the PATCH is in flight so a backdrop tap /
+        // Esc can't dismiss mid-request.
+        if (submitting) return;
         if (!next) onSkip();
       }}
     >
@@ -92,15 +118,19 @@ export function LogInjectionSiteDialog({
         )}
 
         <DialogFooter className="gap-2 sm:gap-2">
-          <Button variant="outline" onClick={onSkip}>
+          <Button variant="outline" onClick={onSkip} disabled={submitting}>
             {t("medications.logInjectionSiteSkip")}
           </Button>
           <Button
-            disabled={selected === null}
+            disabled={selected === null || submitting}
+            aria-busy={submitting || undefined}
             onClick={() => {
-              if (selected !== null) onConfirm(selected);
+              void handleConfirm();
             }}
           >
+            {submitting ? (
+              <Loader2 className="mr-2 h-4 w-4 animate-spin motion-reduce:animate-none" />
+            ) : null}
             {t("medications.logInjectionSiteConfirm")}
           </Button>
         </DialogFooter>
diff --git a/src/components/medications/medication-card.tsx b/src/components/medications/medication-card.tsx
index b3bbdb8bf..c338661c5 100644
--- a/src/components/medications/medication-card.tsx
+++ b/src/components/medications/medication-card.tsx
@@ -250,18 +250,21 @@ export function MedicationCard({
 
   async function confirmInjectionSite(site: InjectionSiteKey) {
     const intakeId = siteIntakeId;
-    setSiteIntakeId(null);
     if (!intakeId) return;
+    // v1.11.5 — keep the dialog open until the PATCH resolves. On failure
+    // surface a toast and re-throw so the dialog stays mounted with the
+    // chosen site instead of dismissing as though the site had been saved.
     const res = await fetch("/api/medications/intake", {
       method: "POST",
       headers: { "Content-Type": "application/json" },
       body: JSON.stringify({ intakeId, status: "taken", injectionSite: site }),
     });
-    if (res.ok) {
-      await invalidateKeys(queryClient, medicationDependentKeys);
-    } else {
-      toast.error(t("medications.logInjectionSiteNoneAvailable"));
+    if (!res.ok) {
+      toast.error(t("medications.logInjectionSiteSaveFailed"));
+      throw new Error("injection-site PATCH failed");
     }
+    await invalidateKeys(queryClient, medicationDependentKeys);
+    setSiteIntakeId(null);
   }
 
   // v1.8.6 — the two compliance windows scale with the dosing cadence. When