Accepted answer
50 units. Volume first: 2.5 mg ÷ 5 mg/mL = 0.5 mL. On a U-100 insulin syringe one unit is 0.01 mL, so 0.5 ÷ 0.01 = 50 units. It lands on a whole graduation, which is what you want from a reconstitution volume.
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.
Two of us worked through this independently and arrived here, so at least it reproduces. – k_szabo 5 months ago 2I have added the label-the-vial suggestion to my own notes. Obvious in hindsight. – tobias_maartens 6 months ago add a comment