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.
The rounding error accumulates if you round too many times — rounding concentration to 5.0, rounding the dose volume to 0.1 mL, rounding the unit reading to 10 — and the safest approach is to work the full precision and round only the final answer.
Reading a lyophilised cake
| Appearance | Interpretation | Action |
|---|
| Intact opaque puck, proud of base | Cycle ran correctly | Proceed |
| Slumped to one side | Shipped before fully dry, or vibration | Usually usable; note it |
| Glassy translucent film | Collapse above glass transition | Test before use |
| Melt-back ring at stopper | Thermal excursion in transit | Test before use |
| No visible cake at all | Very low fill, or nothing there | Weigh it; query the supplier |
Rotation of injection site is a tolerability measure, not a pharmacokinetic one, but if you are going to do it you might as well do it right.
The insulin-unit standard U-100 means 100 units per millilitre, so one unit is 0.01 mL — this is the conversion that trips up more people here than any other single piece of arithmetic.
If in doubt, use more diluent and accept the shorter usable window.
5Thank you — the worked example is what makes this usable. – esther_vandeVelde 7 months ago 6Related: the same reasoning applies to the counter-ion question. – ines_brandt 8 months ago add a comment