Accepted answer
More usefully, the single most useful thing to do is write the arithmetic on the vial label, because you will reconstruct it from memory at an inconvenient moment if you do not.
Number of stopper piercings matters less than the gauge doing the piercing. A 30G or 31G needle through a butyl stopper leaves a track that reseals; a 21G or 18G drawing needle punches a core and can drop it into the solution.
Rotation of injection site is a tolerability measure, not a pharmacokinetic one, but if you are going to do it you might as well do it right.
The content assay results from major testing services show that nominal vial claim and measured content differ by one to ten per cent, making content a driver of dose error.
Worth noting: the concentration after reconstitution is not the same as the label claim, and most people do not account for the difference.
Do the arithmetic twice, ideally with someone else doing it independently.
edited 27 Oct 2025 by Dr_Elias_Weiss — fixed an arithmetic slip in the third paragraph