Accepted answer
The part that matters: before anything else: a kitchen counter with an alcohol wipe is not an aseptic environment, and it is worth being honest about that rather than pretending the procedure is something it is not. What you are doing is reducing bioburden, not achieving sterility.
Write the arithmetic on the vial label. It costs nothing and removes the step where you reconstruct it from memory at an inconvenient moment.
Concentration and unit conversion at a glance
| Vial | Diluent | Concentration | 0.25 mg | 0.5 mg | 1 mg | 2.5 mg |
|---|
| 5 mg | 1 mL | 5 mg/mL | 5 u | 10 u | 20 u | 50 u |
| 5 mg | 2 mL | 2.5 mg/mL | 10 u | 20 u | 40 u | 100 u |
| 10 mg | 1 mL | 10 mg/mL | 2.5 u | 5 u | 10 u | 25 u |
| 10 mg | 2 mL | 5 mg/mL | 5 u | 10 u | 20 u | 50 u |
| 10 mg | 3 mL | 3.33 mg/mL | 7.5 u | 15 u | 30 u | 75 u |
Units are U-100 insulin units, where 1 unit = 0.01 mL. Divide dose by concentration for millilitres, then multiply by 100.
Concretely, do not use the same needle to pierce the stopper and to administer.
The 28-day beyond-use convention for a multiple-withdrawal preserved preparation derives from USP compounding chapters, which set it on microbiological risk rather than chemical stability.
Worth saying: if your arithmetic and someone else's disagree by a factor of ten, one of you has made a unit error.
Do the arithmetic twice, ideally with someone else doing it independently.
4The arithmetic checks out. I ran the same numbers and got the same result. – tobias_maartens 5 months ago add a comment