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Is 10 mg/mL a sensible working concentration for liraglutide, or should I go lower?

Asked 29 May 2024Modified 23 months agoViewed 42k times
36

The case in front of me: 10 mg/mL · liraglutide.

These are treated as interchangeable and I do not think they are.

If both are acceptable I would like to know that, so I can stop thinking about it.

What is the actual trade-off, and does it matter at the scale I am working at?

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askedahmed_zerouali15k1729 May 2024

5 Answers

Accepted answer first, then by votes
90

Accepted answer

At 10 mg/mL a 0.25 mg draw is 2.5 units on a U-100 barrel and a 2.4 mg draw is 24. Those two numbers decide it, because the concentration is only sensible relative to the smallest and largest volumes you will actually measure with it. 2.5 units is too little of the scale to read honestly — half a graduation is 20 per cent of that dose — so going lower in concentration buys resolution you cannot get back after reconstitution. The other consideration is time: a vial you will finish in a fortnight can be concentrated, and a vial you will draw from for months should be split at reconstitution instead.

Aim for a dose volume somewhere between about 10 and 30 units on a U-100 barrel and the reading problem disappears.

Content matters. If the same 10 mg vial assays at 94 per cent content, you have 9.4 mg. In 2 mL that is 4.7 mg/mL, and a nominal 0.5 mg draw of 10 units actually delivers 0.47 mg — a six per cent shortfall that no amount of careful drawing will fix.

Worth being precise here: vial headspace is the hard constraint. A nominal 2 mL vial typically holds a little over 2 mL to the shoulder; adding 3 mL is not an option and attempting it wastes the lot.

Nominal vial volumes in the standard 2R and 3R glass sizes have published brimful capacities well above the nominal fill, but the usable volume is bounded by the stopper displacement.

Concentration equals content over volume, and content is not label claim.

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LC
answered · acceptedlyoph_cake78k26717 Aug 2024
3The dead-space number surprised me until I did the multiplication across twenty draws. – cake_intact 3 months ago
2Worth flagging that the U-40 syringes still exist and this arithmetic does not apply to them. – sian_llewellyn 2 months ago
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25

The honest answer is that a wide range of volumes works and that the extremes at either end cause avoidable problems.

The other direction: 10 mg in 3 mL is 3.33 mg/mL, and a 0.5 mg dose becomes 0.15 mL, or 15 units. More barrel, easier reading, and a larger fraction of the vial volume lost to dead space across the same number of draws.

Round to a diluent volume you can measure accurately. Measuring 1.00 mL on a 1 mL syringe is reliable; measuring 1.37 mL on anything is not, and the error propagates into every dose.

U-100 means 100 units per millilitre by definition, so 1 unit is 0.01 mL and volume in millilitres times one hundred gives units. Every conversion here reduces to that.

Choose the volume that puts your largest intended dose between 10 and 30 units. Everything else follows.

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PC
answeredpierce_count24k3826 Jul 2024
21

Answer first: diluent volume sets concentration and therefore resolution on the syringe barrel, and resolution is free at reconstitution and impossible to recover afterwards.

For a dose that will change during titration, choose the volume for the largest intended dose rather than the first, so the whole schedule fits on one barrel without a mid-vial recalculation.

Worth being precise here: dead-space loss scales with the number of draws, not with the concentration, so a lower concentration spread over more draws loses proportionally less of the total peptide.

Nothing here is medical advice, and research-use material is not approved for human use.

Write the concentration on the label at reconstitution, in units per dose.

edited 8 Jul 2024 by orla_ferriter — added the method parameters

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OF
answeredorla_ferriter89k1484 Jul 2024
7Adding a vote because this deserves more of them. – aine_mulcahy 3 months ago
6Reading the leading edge of the stopper rather than the shoulder is worth a sentence of its own. – Dr_Rosalind_Achebe 2 months ago
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20

Concretely, this is the one decision in the whole preparation sequence that cannot be revised later, which is why it is worth thirty seconds of arithmetic.

Write the concentration and the resulting units-per-dose on the vial label at reconstitution. The arithmetic that is obvious now will not be obvious at six in the morning three weeks from now.

Insulin syringe barrel graduations are typically 1 unit on a 0.3 mL barrel, 1 unit on a 0.5 mL barrel and 2 units on a 1 mL barrel, which is why the barrel size changes what is readable.

Check the vial can physically hold the volume before you draw it up.

edited 21 Aug 2024 by tabular_nums — tightened the wording; no substantive change

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TN
answeredtabular_nums71k486 Aug 2024
-3

The part that matters: the relevant arithmetic is concentration equals vial content divided by diluent volume, and content is not the same as label claim.

Worked example. A 10 mg vial reconstituted with 2 mL gives 5 mg/mL. A 0.5 mg dose is 0.5 ÷ 5 = 0.1 mL, which on a U-100 syringe is 10 units. Reconstitute the same vial with 1 mL and the concentration doubles to 10 mg/mL, the same dose becomes 0.05 mL, and you are now reading 5 units instead of 10 — the same dose at half the resolution.

Measure a volume you can actually measure. Round numbers, real syringes.

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LT
answeredlane_transit60k4728 Aug 2024
7I have added the label-the-vial suggestion to my own notes. Obvious in hindsight. – Dr_Hanne_Solberg 10 months ago
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Not medical advice. Research-use-only compounds are not approved for human use.