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Practice · Reconstitution

Converting between mg/mL and units per dose, both directions

Solved
Solved by electrolyte_notes in post #4
Coming back to post #2, because the follow-up matters more than the original answer. Worked example, since the arithmetic is the whole question. Five milligrams into one millilitre is 5 mg/mL. A 0.25 mg dose is 0.05 mL, which is five units on a U-100 syringe. Check that against your own numbers rather than taking mine.

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IA
i.amankwahTL220 Aug 2024#1

Posting this under the heading it deserves: Converting between mg/mL and units per dose, both directions Everything below is what sits behind that.

Practical question with the units stated, because I have seen how quickly these go wrong without them.

I have a 5 mg vial of retatrutide and I am working to a 1.0 mg step. My syringes are U-100 insulin syringes, 0.5 mL barrel.

I can do the arithmetic and I have done it twice, getting the same answer both times, but I would like someone to check the reasoning rather than the number — specifically whether I have thought about the residual volume correctly, and whether the graduation I am landing on is one a person can actually read.

5 likes 23mo
DM
d.moreauTL2Regular22 Aug 2024#2

Do not shake. Swirl, or leave it. Vigorous agitation introduces air and shear, and neither helps a peptide go into solution any faster than patience does.

Happy to be the one who is wrong here if it settles the question.

9 likes 23mo
YI
y.ibarraTL224 Aug 2024#3

Fine by me. I had wanted a stronger conclusion and there is not one available.

28 likes 23mo
EN
electrolyte_notesTL2Regular Solution26 Aug 2024 · edited#4
d.moreau, post #2: Do not shake. Swirl, or leave it. Vigorous agitation introduces air and shear, and neither helps a peptide go into solution any faster than patience does. Happy to be the one who is wrong here if it settles the question. Go to post

Coming back to post #2, because the follow-up matters more than the original answer.

Worked example, since the arithmetic is the whole question. Five milligrams into one millilitre is 5 mg/mL. A 0.25 mg dose is 0.05 mL, which is five units on a U-100 syringe. Check that against your own numbers rather than taking mine.

7 likes in reply to #2 23mo
BD
b.dumitruTL227 Aug 2024#5

Taking post #4 at face value and following it one step further.

Preservative effectiveness is tested against a defined microbial challenge under defined conditions. It is not a licence to treat an entered vial as sterile indefinitely, and no supplier claims otherwise.

A qualification I should have led with rather than closed on.

0 likes 23mo
NT
nl_translatorTL2Translator · NL29 Aug 2024#6

Do not shake. Swirl, or leave it. Vigorous agitation introduces air and shear, and neither helps a peptide go into solution any faster than patience does.

Reporting the observation and leaving the explanation open deliberately.

5 likes 23mo
VB
v.bruunTL230 Aug 2024#7

Dead volume is the part nobody mentions until it costs them a dose. A fixed-needle insulin syringe holds very little; a detachable-needle luer configuration can hold enough to matter at small doses.

I would treat the number as indicative rather than as a measurement.

21 likes 23mo
DB
d.bramleyTL3Regular1 Sep 2024#8
electrolyte_notes, post #4: Coming back to post #2, because the follow-up matters more than the original answer. Worked example, since the arithmetic is the whole question. Five milligrams into one millilitre is 5 mg/mL. A 0.25 mg dose is 0.05 mL, which is five units on a U-100 syringe. Check that against your own numbers rather than taking mine. Go to post

Do not shake. Swirl, or leave it. Vigorous agitation introduces air and shear, and neither helps a peptide go into solution any faster than patience does.

0 likes in reply to #4 23mo
CO
c.ostergaardTL22 Sep 2024#9
y.ibarra, post #3: Fine by me. I had wanted a stronger conclusion and there is not one available. Go to post

Adding the measurement that post #8 says would settle it.

Preservative effectiveness is tested against a defined microbial challenge under defined conditions. It is not a licence to treat an entered vial as sterile indefinitely, and no supplier claims otherwise.

0 likes in reply to #3 23mo
MS
m.strand_rphTL3Pharmacist3 Sep 2024#10
b.dumitru, post #5: Taking post #4 at face value and following it one step further. Preservative effectiveness is tested against a defined microbial challenge under defined conditions. It is not a licence to treat an entered vial as sterile indefinitely, and no supplier claims otherwise. A qualification I should have led with rather than closed on. Go to post

Noted, and thank you for writing it out rather than summarising it.

2 likes in reply to #5 23mo
CA
c.adebayoTL24 Sep 2024 · edited#11
d.bramley, post #8: Do not shake. Swirl, or leave it. Vigorous agitation introduces air and shear, and neither helps a peptide go into solution any faster than patience does. Go to post

I had written a reply contradicting post #9 and deleted it. Here is what survived.

Do not shake. Swirl, or leave it. Vigorous agitation introduces air and shear, and neither helps a peptide go into solution any faster than patience does.

I would not lead a decision with this, but I would not ignore it either.

0 likes in reply to #8 23mo
HK
h.karlsenTL26 Sep 2024#12

Confirming post #9 from a second method, which matters more than confirming it from a second person.

The best check on any reconstitution calculation is to do it twice by two different routes — mass per volume, then volume per dose — and see whether they agree. They should, and when they do not it is nearly always the concentration step.

Adding it in case it saves somebody the afternoon it cost me.

27 likes 23mo
DB
d.barrosTL27 Sep 2024#13

Swirling until fully clear before drawing is worth the extra minute. A partially dissolved preparation is not uniform and the first dose out of it is not the same as the last.

13 likes 23mo
MI
m.ivaturiTL28 Sep 2024#14
d.moreau, post #2: Do not shake. Swirl, or leave it. Vigorous agitation introduces air and shear, and neither helps a peptide go into solution any faster than patience does. Happy to be the one who is wrong here if it settles the question. Go to post

Preservative effectiveness is tested against a defined microbial challenge under defined conditions. It is not a licence to treat an entered vial as sterile indefinitely, and no supplier claims otherwise.

4 likes in reply to #2 23mo
TV
t.vasquezTL4 Moderator9 Sep 2024#15
m.strand_rph, post #10: Noted, and thank you for writing it out rather than summarising it. Go to post

Do not shake. Swirl, or leave it. Vigorous agitation introduces air and shear, and neither helps a peptide go into solution any faster than patience does.

0 likes in reply to #10 23mo
VB
va.baptistaTL210 Sep 2024#16

Post #13 is right about the mechanism and I think understates the practical bit.

Preservative effectiveness is tested against a defined microbial challenge under defined conditions. It is not a licence to treat an entered vial as sterile indefinitely, and no supplier claims otherwise.

If the premise is wrong, everything after it is decoration.

19 likes 23mo
SC
so.cardosoTL211 Sep 2024#17

The decimal-point error: computing 5 mg / 2 mL as 0.25 mg/mL instead of 2.5 mg/mL is the most common arithmetic error in this subcategory. The habit that catches it: writing the units in every step of the calculation.

Correct me on the arithmetic if it is wrong; I would rather know.

8 likes 23mo
SD
s.dziedzicTL213 Sep 2024#18

Choosing a concentration on purpose rather than by accident: starting with "I want to draw 0.5 mL per dose" and working backward to the required concentration is more efficient than picking a diluent volume and hoping the math works out. State your target volume, then the required concentration follows.

2 likes 22mo
RM
r.mwangiTL214 Sep 2024#19

Do not shake. Swirl, or leave it. Vigorous agitation introduces air and shear, and neither helps a peptide go into solution any faster than patience does.

2 likes 22mo
EC
excursion_checkTL3Regular15 Sep 2024 · edited#20

Preservative effectiveness is tested against a defined microbial challenge under defined conditions. It is not a licence to treat an entered vial as sterile indefinitely, and no supplier claims otherwise.

0 likes 22mo
BW
bac_waterTL2Regular16 Sep 2024#21

Nothing to add on the substance. Thank you for taking the question at face value.

24 likes 22mo
SZ
s.zamoraTL217 Sep 2024#22
d.moreau, post #2: Do not shake. Swirl, or leave it. Vigorous agitation introduces air and shear, and neither helps a peptide go into solution any faster than patience does. Happy to be the one who is wrong here if it settles the question. Go to post

Choose the concentration so that a typical dose lands on a graduation you can actually read. A dose that falls between two marks on a 1 mL barrel is a dose you will get wrong sooner or later.

0 likes in reply to #2 22mo
TD
titration_diaryTL3Regular18 Sep 2024#23

Preservative effectiveness is tested against a defined microbial challenge under defined conditions. It is not a licence to treat an entered vial as sterile indefinitely, and no supplier claims otherwise.

3 likes 22mo
IG
i.guerreroTL219 Sep 2024#24

Everything in post #20 holds. The case it does not cover is the one I have.

Do not shake. Swirl, or leave it. Vigorous agitation introduces air and shear, and neither helps a peptide go into solution any faster than patience does.

If this contradicts something upthread, the upthread version may well be the better one.

11 likes 22mo
EF
e.ferreiraTL3Regular20 Sep 2024#25
s.dziedzic, post #18: Choosing a concentration on purpose rather than by accident: starting with "I want to draw 0.5 mL per dose" and working backward to the required concentration is more efficient than picking a diluent volume and hoping the math works out. State your target volume, then the required concentration follows. Go to post

Building on post #22 rather than restating it.

Reconstituting a multi-strength kit: if a kit contains 5 mg, 10 mg, 15 mg vials and you are reconstituting all of them, writing the concentration on each vial in permanent marker as you go is the single most useful thing you can do to avoid dose errors later.

Flagging that the sources on this are thinner than the confidence in the thread suggests.

17 likes in reply to #18 22mo
HF
h.falkTL221 Sep 2024#26
i.guerrero, post #24: Everything in post #20 holds. The case it does not cover is the one I have. Do not shake. Swirl, or leave it. Vigorous agitation introduces air and shear, and neither helps a peptide go into solution any faster than patience does. If this contradicts something upthread, the upthread version may well be the better one. Go to post

On a U-100 insulin syringe, one hundred units is one millilitre and one unit is 0.01 millilitres. Units are volume marks. They mean nothing until you know the concentration.

Genuinely open to being wrong about this one.

0 likes in reply to #24 22mo
DB
dr_bhattacharyaTL3Physician22 Sep 2024#27

Preservative effectiveness is tested against a defined microbial challenge under defined conditions. It is not a licence to treat an entered vial as sterile indefinitely, and no supplier claims otherwise.

1 like 22mo
TD
t.duarteTL223 Sep 2024 · edited#28

Do not shake. Swirl, or leave it. Vigorous agitation introduces air and shear, and neither helps a peptide go into solution any faster than patience does.

7 likes 22mo
LG
lc_gradientTL3Analytical chemist24 Sep 2024#29
s.dziedzic, post #18: Choosing a concentration on purpose rather than by accident: starting with "I want to draw 0.5 mL per dose" and working backward to the required concentration is more efficient than picking a diluent volume and hoping the math works out. State your target volume, then the required concentration follows. Go to post

Arithmetic step by step: a 5 mg vial with 2 mL of diluent gives (5 mg) / (2 mL) = 2.5 mg/mL. On a U-100 syringe at that concentration, 100 units = 1 mL = 2.5 mg, so each unit = 0.025 mg. A 0.25 mg dose = 0.25 / 0.025 = 10 units. Different concentration: different arithmetic, same principle.

I am confident about the direction and much less about the magnitude.

12 likes in reply to #18 22mo
DV
d.vukovicTL225 Sep 2024#30

On post #28 — agreed on the reasoning, with one qualification.

Do not shake. Swirl, or leave it. Vigorous agitation introduces air and shear, and neither helps a peptide go into solution any faster than patience does.

If that is already documented somewhere, ignore me and link it.

25 likes 22mo