Accepted answer
Work in the order concentration, then volume, then units, and the arithmetic stops being confusing. Concentration is milligrams per millilitre and comes from the vial contents and the diluent volume. Volume per dose is dose divided by concentration. Units on a U-100 syringe are volume in millilitres multiplied by one hundred.
Worked example, because the general form is easier to trust once you have seen it once. Take a 10 mg vial and add 2 mL of diluent: the concentration is 10 ÷ 2 = 5 mg/mL. A 0.5 mg dose is 0.5 ÷ 5 = 0.1 mL. On a U-100 syringe, where 1 unit = 0.01 mL, that is 0.1 ÷ 0.01 = 10 units. Change the diluent to 1 mL and the same dose becomes 5 units — same dose, half the resolution.
Dead space by syringe type
| Configuration | Dead volume | Loss at 5 mg/mL | Over 20 draws |
|---|
| Fixed-needle insulin syringe | 3–5 µL | 15–25 µg | 0.3–0.5 mg |
| Low-dead-space, detachable | <2 µL | <10 µg | <0.2 mg |
| Standard luer-lock + 30G | 35–60 µL | 175–300 µg | 3.5–6 mg |
| Luer-lock + 21G drawing needle | 70–100 µL | 350–500 µg | 7–10 mg |
More usefully, the concentration you actually work with is label claim times content fraction divided by actual diluent volume, which is usually not the same as the nominal concentration because content is usually not 100 per cent and you rarely measure the diluent volume to 0.1 mL precision.
The Arrhenius relationship for drawing kinetics means that cold solution takes noticeably longer to draw than room-temperature solution.
The caveat is that this assumes the vial contains what the label says, and if the content assay has not been done, the arithmetic is precise about an unknown quantity.
Write the arithmetic on the vial label. It costs nothing and removes the step where you reconstruct it from memory.