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c/reconstitution·posted 2 years ago by u/swirl_dont_shake

[PSA] mg/mL is not what most of this community thinks it is

PSA Clean Column ×7 Well Actually ×3 Long Haul ×3

mg/mL is not what most of this community thinks it is — with the reasoning, because a rule without a reason gets ignored.

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.

Spent 17 weeks confused about this until somebody drew the table for me. 10mg, 3mL, 3.33mg/mL, 1mg is 30 units. That is the whole thing.

The whole calculation, once, with real numbers.

You have a 10mg vial. You add 2mL of bacteriostatic water. Concentration is mass over volume: 5mg/mL. A U-100 insulin syringe is graduated at 100 units per millilitre, so one unit is 0.01mL.

To draw 5mg you need 5 divided by 5 millilitres, which is 100 units on the barrel. Write "5mg/mL" on the vial in marker before you put it away, and you never have to do this again for that vial.

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

13,945 up / 1,725 down89% upvoted23 commentsid 1ifp4n10 Jan 2024

23 comments

4 in this archive, depth 2

best — the order this archive was captured in

u/quarter_dose_queenlow and slow0 points·2 years ago

Aim the stream down the wall of the vial rather than into the cake. Reconstitution is a solubility problem, not a mixing problem, and mechanical shear does nothing helpful.

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u/priya_guerrero1.8k points·2 years ago

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

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u/piotr_bruun823 points·2 years ago

Careful — that arithmetic is wrong. 10mg in 3mL is 3.33mg/mL, so 1.5mg draws to 45 units, not what you wrote.

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u/emil_wojcik1.1k points·2 years 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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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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