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c/reconstitution·posted 1 year ago by u/ledger_mod

[Discussion] the insulin syringe advice in here is 2 years out of date

Discussion Well Actually ×1

the insulin syringe advice in here is 2 years out of date, and I am aware this is a minority view on this board.

The numbers the title promised, since a headline without them is worthless: 2 years. Everything below is context for those.

Shook the first vial because nobody told me not to. It was fine, but I have swirled every one since.

The dead space question sent me down a rabbit hole for a week. It is a fraction of a unit and it is the same every draw.

If two or three other people have done the same thing we might actually learn something. Alone it is an anecdote.

921 up / 274 down77% upvoted30 commentsid l59c0u17 Aug 2024

30 comments

26 in this archive, depth 5

best — the order this archive was captured in

u/honest_syringe_20250 points·1 year ago

I keep a laminated card in the drawer with the arithmetic on it. Looks ridiculous. Has never once let me draw the wrong volume.

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u/saskia_rahimi72 points·1 year ago

Adding more water does not change how much peptide is in the vial. It changes the concentration, which changes the volume you draw for the same amount. That is the entire relationship.

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[removed]28 points·1 year ago

[removed by moderator]

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u/zaid_balogun23 points·1 year ago

This. Showing the working is the fastest way for somebody else to spot the mistake.

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u/quarter_dose_queenlow and slow37 points·1 year ago

The arithmetic in full: concentration is mass over volume, so 20mg into 2mL gives 10mg/mL. A U-100 syringe is graduated at 100 units per millilitre, so 5mg is 5 divided by 10 millilitres, which is 50 units.

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u/ledger_modOPmod · vetting22 points·1 year ago·edited

Spent 18 weeks confused about this until somebody drew the table for me. 20mg, 3mL, 6.67mg/mL, 2mg is 30 units. That is the whole thing.

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u/julia_erdogan11 points·1 year ago

if the maths gives you a fraction of a unit, change the concentration

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u/ledger_modOPmod · vetting8 points·1 year ago

Small fix — a U-100 syringe is 100 units per mL. If yours is marked differently it is not U-100 and the whole calculation changes.

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u/declared_value_dv5 points·1 year ago

twice as much water halves the concentration and doubles the units for the same dose

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u/ledger_modOPmod · vetting-13 points·1 year ago

The arithmetic in full: concentration is mass over volume, so 20mg into 2mL gives 10mg/mL.

Disagreeing with this line only: adding more water is not a safety margin, it is a different divisor.

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u/escrow_evangelist1 point·1 year ago·edited

Yes. Writing 30mg/mL on the vial takes four seconds and removes the entire class of error this board exists to fix.

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u/arne_restrepo20 points·1 year ago

Careful — that arithmetic is wrong. 15mg in 3mL is 5mg/mL, so 0.25mg draws to 5 units, not what you wrote.

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u/georgi_adebayo16 points·1 year ago

aim the stream at the glass wall, not at the cake

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u/andres_sorensen14 points·1 year ago

Asked SGN what volume they reconstitute to for their own stability testing and they answered in one line. Useful thing to know.

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u/bac_water_banditMOD10 points·1 year ago

Left up and flaired Explainer — the numbers in this one check out.

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u/yusuf_achebe7 points·1 year ago

That is sterile water, not bacteriostatic. Same appearance, different product, and it matters for a multi-draw vial.

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u/dexa_twice_yearlybody comp16 points·1 year ago

Bacteriostatic water contains benzyl alcohol as a preservative, which is what makes repeated entry into the same vial reasonable. Plain sterile water has no preservative.

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u/georgi_adebayo9 points·1 year ago

Reconstituted at 1mL when I meant to use a different volume. Caught it because the units looked wrong on the barrel. Now I write 15mg/mL on the glass before I put the cap back.

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u/priya_weiss4 points·1 year ago

I would not round that figure. At 5mg/mL a rounding error of two units is a real fraction of the intended amount.

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u/karl_fischer_kev3 points·1 year ago

Disagree with the "more water is safer" framing. It is not safer, it is just a different number to divide by.

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u/bac_water_banditreconstitution9 points·1 year ago

Bacteriostatic or plain sterile water?

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u/emil_zamora4 points·1 year ago·edited

Bacteriostatic or plain sterile water?

Adding one thing — put the date on the label too. Concentration plus date and you can never mix two vials up.

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u/cesar_ivaturi5 points·1 year ago

Wrote the date on the vial as well as the concentration after losing track of which one was opened first.

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u/ismael_nwosu4 points·1 year ago

Started reconstituting everything to a round concentration and the six-in-the-morning error rate went to zero.

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u/freya_onwuka0 points·1 year ago

Correction: that gives 5 units, not what you have written. 15mg into 1mL is 15mg/mL and the division follows from there.

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u/lyophile_lou5 points·1 year ago

The lyophilised cake displaces a small volume, so the true concentration is very slightly lower than the arithmetic suggests. It is a fraction of a percent and it is dwarfed by fill tolerance.

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About c/reconstitution

The arithmetic and the technique. Bacteriostatic versus sterile water, reconstitution volume as a concentration choice, converting mg/mL into insulin-syringe units, dead space, swirl-not-shake, stopper coring, and how long a reconstituted vial is actually good for. Math errors get corrected fast and politely.

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