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

does reconstitution actually matter or is it forum lore at this point

Explainer Cold Box ×3 Well Actually ×1

Slightly embarrassed to be asking this, but: does reconstitution actually matter or is it forum lore at this point.

Spent 20 weeks confused about this until somebody drew the table for me. 10mg, 2mL, 5mg/mL, 2mg is 40 units. That is the whole thing.

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

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

Corrections welcome, especially the pedantic ones. Pedantry is how this board earns its reputation.

2,743 up / 940 down74% upvoted66 commentsid 15hvaz2 May 2025

66 comments

30 in this archive, depth 5

best — the order this archive was captured in

u/swirl_dont_shakereconstitution140 points·1 year ago

The failure modes I have actually seen posted here, in order of frequency.

One: reconstituting at a different volume than intended and not writing it down, so the next draw is based on a remembered concentration. Two: treating units as a dose rather than a volume, which breaks the moment the concentration changes. Three: assuming a syringe is U-100 when it is not.

All three are solved by the same two habits — do the arithmetic before the water goes in, and write the result on the glass. Neither costs anything and between them they cover almost every question this board gets.

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u/a1c_arcT2D39 points·1 year ago

Asked JEEP 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/marisol_frisk19 points·1 year ago

Asked JEEP what volume they reconstitute to for their own stability testing and they answered in one line.

This is the sentence that makes the rest unnecessary. Write it on the vial and the problem is gone.

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u/quiet_reader_99-33 points·1 year ago

reconstituting at a round concentration makes every later dose easy

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u/aurel_boateng12 points·1 year ago

Did the maths give you a whole number of units, or a fraction?

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u/aleksi_lehtinen10 points·1 year ago

swirl, never shake

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u/bac_water_banditMOD73 points·1 year ago

Reminder: this board does maths, not dosing. Nobody here tells another member what amount to take.

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u/honest_syringe_202522 points·1 year ago

more water is not more drug, it is the same drug in a bigger volume

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u/liv_nkemelu20 points·1 year ago

dead space in the needle hub is real and it is small

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u/yusuf_achebe81 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/declared_value_dv61 points·1 year ago

Correction: that gives 20 units, not what you have written. 15mg into 2mL is 7.5mg/mL and the division follows from there.

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u/quiet_reader_9980 points·1 year ago

Pushback on the syringe advice: a U-100 barrel reads units of volume. Calling them "doses" is how the confusion starts.

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u/oskar_ibarra63 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/arne_restrepo17 points·1 year ago

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

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u/ruben_cabrera14 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/viktor_erdogan38 points·1 year ago·edited

If your calculation produces a fraction of a unit, the concentration is wrong for your dose. Change the water volume until the numbers land on whole units.

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u/emil_zamora11 points·1 year ago

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

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u/runa_cabreraOP9 points·1 year ago

Reconstituted at 3mL when I meant to use a different volume. Caught it because the units looked wrong on the barrel. Now I write 5mg/mL on the glass before I put the cap back.

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u/runa_grimaldi13 points·1 year ago

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

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u/georgi_adebayo28 points·1 year ago

bacteriostatic water has the preservative, sterile water does not

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u/andres_sorensen0 points·1 year ago

I would not round that figure. At 10mg/mL a rounding error of two units is a real fraction of the intended amount.

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u/emil_okwuosa1 point·1 year ago

do the arithmetic before you reconstitute, not while holding a syringe

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u/emil_wojcik1 point·1 year ago

units are a volume on a U-100 syringe, not a dose

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u/vial_math_verasyringe math0 points·1 year ago

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.

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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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