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Is 20 mg in 2 mL of bacteriostatic water a sensible presentation for liraglutide?

Asked 12 Apr 2025Modified 12 months agoViewed 14k times
28

Setup, so nobody has to ask: 20 mg · 2 mL · bacteriostatic water · liraglutide.

I am trying to build something sustainable rather than something thorough that I will abandon.

I have already decided the broad direction; this is about the specifics.

What should I decide now, and what should I defer?

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NK
askednadia_kowalczyk14k1712 Apr 2025

5 Answers

Accepted answer first, then by votes
41

Accepted answer

More usefully, write the units at every step, because units errors are the failure mode that catches everyone eventually.

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.

Worth being precise here: air bubbles at these volumes are a measurement problem rather than a safety one. A 2 mm bubble in a 0.3 mL syringe is roughly 4 µL, which at 10 units drawn is a four per cent error.

Published data on syringe dead space quantifies low-dead-space designs as retaining under 2 µL against 35 µL or more for conventional detachable-needle syringes.

Do the arithmetic twice, ideally with someone else doing it independently.

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DV
answered · acceptedDr_Bram_Verhoeven85k2482 Aug 2025
Good answer, but the confidence interval in the cited trial is wider than implied. – Dr_Priya_Raghunathan 5 days ago
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35

Rounding to the nearest whole syringe unit is usually the right error to make, but understanding which direction it is and why matters.

Worked example, because the general form is easier to trust once you have seen it once. Take a 10 mg vial and add 2 mL of diluent: the concentration is 10 ÷ 2 = 5 mg/mL. A 0.5 mg dose is 0.5 ÷ 5 = 0.1 mL. On a U-100 syringe, where 1 unit = 0.01 mL, that is 0.1 ÷ 0.01 = 10 units. Change the diluent to 1 mL and the same dose becomes 5 units — same dose, half the resolution.

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.

If in doubt, use more diluent and accept the shorter usable window.

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DW
answeredDr_Elias_Weiss46k3822 Jul 2025
4This matches what I was told by a laboratory, for whatever that is worth. – p_mkhize 5 months ago
5Minor: the trial name is hyphenated in the original publication. – plate_count_9k 7 months ago
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19

Dose arithmetic has three parts: concentration from vial content and diluent, volume from dose and concentration, and units from volume and syringe scale.

Breaking it down further: if a 10 mg vial has 96.5 per cent content, you have 9.65 mg of peptide. Divide that by 2.00 mL and your concentration is 4.825 mg/mL, not 5.00 mg/mL, which is a 3.5 per cent systematic error in every dose calculation.

Worth being precise here: do not use the same needle to pierce the stopper and to administer. The tip is blunted by the stopper, and the hub now contains a dose you are about to lose to dead space anyway.

Write the arithmetic on the vial label. It costs nothing and removes the step where you reconstruct it from memory.

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ED
answerede_dziedzic87k24816 Apr 2025
15

Concretely, the common error is getting the concentration right but then misreading the syringe scale, which is why checking the barrel marking rather than your memory matters.

Room temperature before drawing is worth the ten minutes. Cold solution is more viscous, draws slower, and condensation on a cold barrel makes it harder to read the meniscus.

One qualification: if your arithmetic and someone else's disagree by a factor of ten, one of you has made a unit error, and writing out the units at every step is the diagnostic.

Do the arithmetic twice, ideally with someone else doing it independently.

edited 11 May 2025 by otto_brenner — reworded for clarity after a comment

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OB
answeredotto_brenner19k2827 Apr 2025
14

The relevant detail is that the answer depends on exactly which dose and which vial you are asking about, but the method is always the same.

The concentration you actually work with is label claim times content fraction divided by actual diluent volume, which is usually not the same as the nominal concentration because content is usually not 100 per cent and you rarely measure the diluent volume to 0.1 mL precision.

The Arrhenius relationship for drawing kinetics means that cold solution takes noticeably longer to draw than room-temperature solution.

I would flag the obvious failure mode: people get the concentration right, get the volume right, and then read the syringe against the wrong scale.

If in doubt, use more diluent and accept the shorter usable window.

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TG
answeredtandem_gradient85k2488 Jun 2025
8For what it is worth, my own result was within half a per cent of this. – vial_five 30 days ago
7Any reason this would differ for a longer peptide? – tobias_maartens 9 months ago
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