Accepted answer
The single most useful thing to do is write the arithmetic on the vial label, because you will reconstruct it from memory at an inconvenient moment if you do not.
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.
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 |
Concretely, 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.
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.
Worth noting: the concentration after reconstitution is not the same as the label claim, and most people do not account for the difference.
If in doubt, use more diluent and accept the shorter usable window.
This is the first explanation of that which has actually made sense to me. – esther_vandeVelde 6 months ago Note that the label instructions differ between agents on precisely this point. – thabo_maseko 5 months ago add a comment