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

unpopular opinion: most of what gets said here about reconstitution is guesswork

Discussion Slow Clap ×7 Sourced ×3 Clean Column ×2

unpopular opinion: most of what gets said here about reconstitution is guesswork — a position I have arrived at slowly and would like tested.

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

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.

Not medical advice, obviously, and nothing here is approved for human use. One person with a spreadsheet.

32,323 up / 23,951 down57% upvoted46 commentsid gpiuf98 Mar 2024

46 comments

30 in this archive, depth 6

best — the order this archive was captured in

u/RetaAndRegret2929 points·2 years ago

a U-100 syringe reads 100 units to the millilitre, every time

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u/rasmus_mensah742 points·2 years ago

a U-100 syringe reads 100 units to the millilitre, every time

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

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u/viktor_kirchner773 points·2 years 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/vial_math_verasyringe math257 points·2 years ago

Careful — that arithmetic is wrong. 10mg in 2mL is 5mg/mL, so 1.5mg draws to 30 units, not what you wrote.

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u/vial_math_veraOPsyringe math159 points·2 years ago

label the vial with the date as well as the concentration

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u/wanjiru_varga0 points·2 years ago

Bacteriostatic water contains benzyl alcohol as a preservative, which is what makes repeated entry into the same vial reasonable.

viktor_kirchner has the units point exactly right. They are a volume on the barrel and nothing else.

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u/RetaAndRegret21 point·2 years ago

viktor_kirchner has the units point exactly right.

Right, and the arithmetic behind it: 10mg in 1mL is 10mg/mL, so 2mg is 20 units.

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u/clara_weiss520 points·2 years ago

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/erez_perrin366 points·2 years 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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u/hedda_ekstrom289 points·2 years 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/aurel_boateng233 points·2 years 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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u/sock_puppet_spotter-38 points·2 years ago

The arithmetic in full: concentration is mass over volume, so 5mg into 1mL gives 5mg/mL. A U-100 syringe is graduated at 100 units per millilitre, so 2mg is 2 divided by 5 millilitres, which is 40 units.

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u/priya_guerrero66 points·2 years ago

Research-use-only material is not approved for human use, so treat everything in this thread as arithmetic about solutions rather than instructions for a person.

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u/arto_falk82 points·2 years ago

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

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u/sofia_danquah19 points·2 years 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/karim_ilunga0 points·2 years ago

I keep a laminated card in the drawer with the arithmetic on it.

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

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u/saskia_mwangi13 points·2 years ago

Not quite. Bacteriostatic and sterile water are not interchangeable for a multi-draw vial, and the difference is the preservative.

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u/emil_okwuosa10 points·2 years ago

Asked KP 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/hedda_ekstrom50 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/mateusz_achebe31 points·2 years ago

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

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u/aleksi_lehtinen25 points·2 years ago

reconstituting at a round concentration makes every later dose easy

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u/ismael_nwosu158 points·2 years ago

the powder cake sits at the bottom, the volume you add is the volume that counts

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u/elin_ferrari147 points·2 years ago

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

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u/kenji_kimani49 points·2 years ago

Yes. Writing 5mg/mL on the vial takes four seconds and removes the entire class of error this board exists to fix.

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u/katrin_marchetti74 points·2 years ago

bacteriostatic water has the preservative, sterile water does not

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u/rosa_mensah34 points·2 years ago·edited

Spent 10 weeks confused about this until somebody drew the table for me. 20mg, 3mL, 6.67mg/mL, 5mg is 75 units. That is the whole thing.

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u/swirl_dont_shakeMOD89 points·2 years ago·edited

Corrected the concentration in the title, which contradicted the body. Nothing else touched.

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u/sofia_danquah26 points·2 years ago

swirl, never shake

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u/bruno_dumitru66 points·2 years 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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u/anya_antonsen33 points·2 years 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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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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