Accepted answer
40 units. Volume first: 8 mg ÷ 20 mg/mL = 0.4 mL. On a 0.5 mL insulin syringe one unit is 0.01 mL, so 0.4 ÷ 0.01 = 40 units. It lands on a whole graduation, which is what you want from a reconstitution volume.
The answer depends on exactly which dose and which vial you are asking about, but the method is always the same.
Dead space quantified: a fixed-needle insulin syringe holds roughly 3 to 5 µL in the hub and needle after the plunger bottoms out. A luer-lock syringe with a detachable needle holds 35 to 100 µL depending on the hub design. At 5 mg/mL that is 15 to 25 µg lost per draw on the insulin syringe and 175 to 500 µg on the luer-lock — which over ten draws is the difference between losing a rounding error and losing half a milligram.
The underlying point is that 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.
Published data on syringe dead space quantifies low-dead-space designs as retaining under 2 µL against 35 µL or more for conventional detachable-needle syringes.
If in doubt, use more diluent and accept the shorter usable window.
edited 23 Jun 2024 by u100_marks — added a caveat about sampling