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How do I get 12 units out of a vial reconstituted to 5 mg/mL without guessing?

Asked 26 Mar 2024Modified 2.0 years agoViewed 65k times
This question was marked as a duplicate of How many units on a 0.3 mL insulin syringe is a 5 mg dose at 20 mg/mL?Closed 31 Mar 2024. It remains here because the answers below are specific to how it was asked.
40

Conditions: 12 units · 5 mg/mL.

I am trying to do this correctly the first time rather than learn it by getting it wrong.

I have already made one mistake here that cost me a vial, so I am being deliberately careful.

What would you do, and what would you check afterwards?

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RP
askedrhian_prydderch23k2726 Mar 2024

5 Answers

Accepted answer first, then by votes
-2

Accepted answer

12 units is 0.12 mL, which at 5 mg/mL is 0.6 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 relevant precision limit is that you cannot reliably read half a graduation, so the barrel decides the smallest change you can make.

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.

Concentration and unit conversion at a glance

VialDiluentConcentration0.25 mg0.5 mg1 mg2.5 mg
5 mg1 mL5 mg/mL5 u10 u20 u50 u
5 mg2 mL2.5 mg/mL10 u20 u40 u100 u
10 mg1 mL10 mg/mL2.5 u5 u10 u25 u
10 mg2 mL5 mg/mL5 u10 u20 u50 u
10 mg3 mL3.33 mg/mL7.5 u15 u30 u75 u

Units are U-100 insulin units, where 1 unit = 0.01 mL. Divide dose by concentration for millilitres, then multiply by 100.

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.

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

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 25 Jul 2024 by tabular_nums — reworded for clarity after a comment

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TN
answered · acceptedtabular_nums71k4813 Jul 2024
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73

Answering this needs to know whether the syringe is U-100 or U-40, since a U-40 syringe used with the U-100 conversion produces a two-and-a-half-fold error.

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.

On the detail: 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.

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.

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

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DV
answereddead_volume56k482 Jul 2024
35

Answer first: on a U-100 syringe one unit is 0.01 mL, so units are simply volume in millilitres multiplied by one hundred. Nothing else about the scale is doing any work.

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.

Mechanically, 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.

Graduation intervals by barrel size are printed on the packaging and are the practical limit on dosing resolution.

Nothing here is medical advice.

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

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TN
answeredtabular_nums71k489 Jun 2024
3Same experience here, different supplier. – m_haraldsen 2 months ago
4Adding that a fixed-needle syringe loses about a tenth of what a luer one does. – sian_llewellyn 4 months ago
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28

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

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.

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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DV
answereddead_volume56k4821 Jun 2024
5Worth flagging that the U-40 syringes still exist and this arithmetic does not apply to them. – dead_volume 8 months ago
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27

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.

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

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

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TU
answeredtenth_of_a_unit57k3718 May 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.