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How do I get 10 units out of a vial reconstituted to 1 mg/mL without guessing?

Asked 11 Sept 2024Modified 19 months agoViewed 44k times
32

Numbers first: 10 units · 1 mg/mL.

I would like to understand the steps well enough to explain them to someone else.

I have access to a refrigerator with a logger and a freezer without one, which may be relevant.

Concretely, what should I do, and how would I know afterwards whether I did it right?

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VR
askedvalentina_rossi9.7k1611 Sept 2024

5 Answers

Accepted answer first, then by votes
28

Accepted answer

10 units is 0.1 mL, which at 1 mg/mL is 0.1 mg. Work it in that order and there is nothing to guess at: units to volume on the U-100 scale, volume to dose through the concentration. Draw with the barrel vertical, expel the air before you read, and read the leading edge of the plunger stopper rather than the shoulder — the difference between the two is about a unit on a 0.3 mL barrel.

The honest answer is that most dosing errors in this tag are reading errors rather than calculation errors.

The conversion in full: volume in mL = dose in mg ÷ concentration in mg/mL; units = volume × 100. At 5 mg/mL, a 0.25 mg dose is 0.05 mL, which is 5 units. At the same concentration a 1 mg dose is 0.2 mL, which is 20 units.

Reading a lyophilised cake

AppearanceInterpretationAction
Intact opaque puck, proud of baseCycle ran correctlyProceed
Slumped to one sideShipped before fully dry, or vibrationUsually usable; note it
Glassy translucent filmCollapse above glass transitionTest before use
Melt-back ring at stopperThermal excursion in transitTest before use
No visible cake at allVery low fill, or nothing thereWeigh it; query the supplier

Needle length for subcutaneous administration is conventionally 4 to 8 mm; the 4 mm length is sufficient for essentially all adults and reduces the chance of an intramuscular injection.

The 4 mm needle length is supported by injection-technique studies showing adequate subcutaneous delivery across body-mass ranges without increased intramuscular delivery.

One unit is 0.01 mL on U-100. That is the whole scale.

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LW
answered · acceptedlinnea_wahlberg17k271 Jan 2025
2Does this change at lower concentrations, or does adsorption start to dominate? – orla_ferriter 3 months ago
3Minor: the filter membrane chemistry matters as much as the pore size for adsorption. – orla_sheridan 5 months ago
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20

The short version: U-100 only, smallest barrel that fits the dose, read the leading edge of the plunger stopper.

Fixed-needle insulin syringes retain roughly 3 to 5 microlitres after the plunger bottoms out. Detachable-needle luer syringes retain 35 to 100 microlitres depending on hub design — an order of magnitude more.

Mechanically, syringes are single-use. Reusing one blunts the tip against the stopper, degrades the silicone coating and makes the graduation reading no more accurate than it was the first time.

Published dead-space comparisons put low-dead-space fixed-needle designs under 2 microlitres and conventional detachable-needle designs at 35 microlitres or more.

The caveat is that this describes an instrument, not a treatment, and research-use compounds are not approved for human use.

Read the leading edge of the stopper, every time.

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TN
answeredtabular_nums71k4814 Sept 2024
6Thank you — the worked example is what makes this usable. – tyndall_haze 7 months ago
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10

The relevant precision limit is that you cannot reliably read half a graduation, so the barrel decides the smallest change you can make.

A 2 mm air bubble in a 0.3 mL barrel is about 4 microlitres, which against a 10-unit (100 microlitre) draw is a four per cent error. Flick it to the hub and expel it before reading.

Read the leading edge of the rubber plunger stopper against the graduation, not the tip of the conical shoulder. The difference is roughly one unit on a 0.3 mL barrel, which is a four per cent error on a 25-unit dose.

Half-graduation estimation is not measurement. If the dose needs it, change the concentration instead.

Smallest barrel that holds the dose. Resolution is free and you should take it.

edited 3 Oct 2024 by low_dead_space — fixed an arithmetic slip in the third paragraph

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LS
answeredlow_dead_space37k3725 Sept 2024
4

This is arithmetic and instrumentation, and both halves are simple once stated.

U-40 syringes still exist, mostly in veterinary supply. A U-40 barrel marked "20 units" holds 0.5 mL, not 0.2 mL. Using one with U-100 arithmetic overdoses by a factor of two and a half.

U-100 is a concentration standard meaning 100 units of insulin per millilitre; the syringe graduation is a volume scale expressed in those units.

Check the syringe is U-100 and not U-40 before doing any arithmetic with it.

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KM
answeredkofi_mensah18k2729 Oct 2024
2Reading the leading edge of the stopper rather than the shoulder is worth a sentence of its own. – Dr_Rosalind_Achebe 4 months ago
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-3

Start with the barrel size, because a 0.3 mL barrel graduated in single units and a 1 mL barrel graduated in twos are different instruments for this purpose.

Barrel sizes and graduations: 0.3 mL barrels are marked in single units to 30, 0.5 mL barrels in single units to 50, and 1 mL barrels usually in two-unit increments to 100. The smallest barrel that holds the dose gives the finest reading.

If your arithmetic and someone else's differ by a factor of ten, one of you has misplaced a decimal rather than misunderstood the biology.

Fixed needle, not detachable, unless you have a specific reason.

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UM
answeredu100_marks52k376 Oct 2024

Your answer

Ask PeptideStack is a static archive. Posting is closed, but the norms are worth stating: answer the question that was asked, show your working, cite the trial or the certificate, and say plainly where the evidence runs out.

Not medical advice. Research-use-only compounds are not approved for human use.