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Is a 25G drawing needle the right choice for drawing oral semaglutide at 1 mg/mL?

Asked 22 Mar 2024Modified 2.1 years agoViewed 26k times
15

The case in front of me: a 25G drawing needle · oral semaglutide · 1 mg/mL.

I would like the axes of comparison first and the recommendation second.

I have tried the first option and it works; the question is whether the second is better rather than merely different.

Is there a defensible reason to prefer one, or is this a coin flip?

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OF
askedorla_ferriter89k14822 Mar 2024
7Worth stating whether you have a content assay, because the calculation assumes label claim. – thermal_mass 5 months ago
6Same question, and I got two answers that differ by a factor of ten, so I am watching this. – Dr_Priya_Raghunathan 3 months ago
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5 Answers

Accepted answer first, then by votes
82

Accepted answer

At 1 mg/mL a 1 mg dose is 1 mL — 100 units on a U-100 barrel — and no needle gauge changes that number. Gauge changes three other things: how long the draw takes, how much stays behind in the hub, and how much rubber you core out of the stopper. On the 25G scale a larger number is a finer needle, so a 25G drawing needle is coarse enough to draw quickly and coarse enough to cut a visible plug from the stopper. If you are drawing 100 units at a time, the dead space matters more than the bore: a fixed-needle barrel loses microlitres, a luer hub loses tens of them, and at 1 mg/mL each microlitre is 1 µg.

Answering this needs to know the viscosity of what is being drawn, since a viscous solution through a fine needle is slow enough to encourage bad technique.

Typical outer diameters: 21G is about 0.82 mm, 23G about 0.64 mm, 25G about 0.51 mm, 29G about 0.34 mm and 31G about 0.26 mm. The gauge number and the diameter move in opposite directions.

The underlying point is that drawing a viscous or foamy solution through a fine needle takes long enough that people rush the plunger, which causes more foaming. Using a wider drawing needle is the fix.

Needle gauge to outer diameter correspondence is standardised and published; the inverse relationship between gauge number and diameter is the reason for the counter-intuitive labelling.

Length affects comfort more than gauge does at these volumes.

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UM
answered · acceptedu100_marks52k3726 Jun 2024
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73

Specifically, coring the stopper with a large-bore needle is the risk at the drawing end, and it is real.

A 30G or 31G needle through a butyl stopper leaves a track that reseals, which is why fine-gauge repeated entry is tolerable and coarse-gauge repeated entry is not.

The part that matters: very fine needles are more prone to bending and to blocking with any particulate, which is a practical argument for inspecting the solution before drawing.

Butyl rubber closures are specified for resealing after piercing up to a stated gauge, which is the basis for the fine-gauge repeated-entry practice.

Big to draw, small to inject, never the same one twice.

edited 15 Jun 2024 by per_haugen — added the method parameters

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PH
answeredper_haugen13k1715 Jun 2024
3Adding that a fixed-needle syringe loses about a tenth of what a luer one does. – Dr_Colm_Fitzhenry 6 months ago
4Two of us worked through this independently and arrived here, so at least it reproduces. – pieter_maas 8 months ago
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35

Start with the fact that gauge numbers run backwards — a higher number is a thinner needle — which is the source of half the confusion in this tag.

Stopper coring — punching a disc of rubber into the solution — is a large-bore phenomenon. An 18G or 21G needle inserted straight and fast is the classic way to do it; inserting at a slight angle with the bevel up reduces the risk.

Specifically, fixed-needle insulin syringes are supplied in 29G to 31G and cannot be swapped for drawing, which is the trade-off against their much lower dead space.

The Hagen–Poiseuille relation gives flow proportional to the fourth power of radius, which is the quantitative basis for every gauge recommendation here.

Higher gauge is not automatically better; it is thinner, which has costs as well as benefits.

Angle the bevel and insert gently to avoid coring the stopper.

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VR
answeredv_ramaswamy68k5724 May 2024
28

Put another way, this is a straightforward answer that people over-complicate because the numbering is counter-intuitive.

Flow through a needle scales with the fourth power of the internal radius under the Hagen–Poiseuille relation. Halving the radius reduces flow sixteen-fold at the same pressure, which is why a 31G needle draws so much more slowly than a 21G.

Coring risk as a function of needle gauge and insertion technique is documented in pharmacy compounding guidance.

If a solution will not draw through a 25G needle, the problem is the solution rather than the needle.

Flow goes as the fourth power of radius. That is why the difference feels so large.

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MM
answeredmg_per_ml15k164 Jun 2024
8I have added the label-the-vial suggestion to my own notes. Obvious in hindsight. – h_pergande 9 months ago
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23

The relevant physics is the fourth-power dependence of flow on radius, which makes small gauge differences enormous in practice.

For injecting, 29G to 31G is the usual range and the difference in perceived discomfort between them is small. Needle length matters more than gauge for comfort at these volumes.

Nothing here is medical advice.

Gauge numbers run backwards. Higher number, thinner needle.

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LB
answeredlaminar_bench69k5731 Mar 2024
3Would this be different for a peptide that foams? Mine does and I have never known why. – mg_per_ml 34 days ago
2Confirming: I did the wrong thing here once and got exactly the predicted result. – lyoph_cake 9 months ago
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