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ForumsDosing & ProtocolsInsulin syringe unit conversion for compounded sema — 12 month update

Insulin syringe unit conversion for compounded sema — 12 month update

BrianDallas92 Tue, Dec 17, 2024 at 3:18 AM 34 replies 1,924 viewsPage 1 of 7
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BrianDallas92
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Dallas, TX
Dec 17, 2024 at 3:18 AM#1

I reconstituted a 10mg vial with 2ml of bacteriostatic water and I want someone to check my unit arithmetic before I draw anything, because I keep getting two different answers.

The narrow version of the question is how to check the arithmetic without trusting a website calculator, since three calculators gave me three answers.

Not looking for reassurance. Looking for the part I have got wrong.

2 22Dr.PathRoch, mona_PHX
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DataDave
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Dec 17, 2024 at 3:23 AM#2

Answering the narrow version, because the broad one does not have a single answer. Do it in two steps and it stops being confusing. First concentration: 10mg into 2ml is 5mg/ml. Then volume: a 0.5mg dose is 0.5 ÷ 5 = 0.1ml. Then units, and this is where people go wrong — a U-100 syringe is graduated in hundredths of a millilitre, so 0.1ml is 10 units. The word "units" has nothing to do with milligrams; it is a volume marking that exists because insulin happens to come at 100 units per ml.

1 21mike_nyc
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tyler_CSCS
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Dec 17, 2024 at 3:28 AM#3
DataDave said:
Do it in two steps and it stops being confusing.

DataDave has the substance of this right. The condition it depends on is worth stating. The arithmetic is right and one caveat matters: a U-40 syringe changes the markings, not the volumes. If someone hands you U-40 and you read it as U-100 you will be 2.5 times out, and that error has a direction — it is always an overdose.

Last edited: Dec 17, 2024 at 5:28 AM
50 20Dr.SportsMedIN, amy_econ_NJ, bbq_ray_KC and 47 others
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pam_columbus
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Dec 17, 2024 at 3:33 AM#4
BrianDallas92 said:
I reconstituted a 10mg vial with 2ml of bacteriostatic water and I want someone to check my unit arithmetic before I draw anything, because I keep…

Same position here, arrived at the long way round. Concentration choice is a precision decision, not a preference. Reconstitute high and every dose is a tiny volume where one unit of syringe error is a large fraction of the dose. Reconstitute low and you get more graduations per dose, so the same hand tremor costs proportionally less. Against that, more diluent means more benzyl alcohol and a shorter comfortable in-use window.

49 19tammy_FL, Dr.LipidDallas, alex_tucson and 46 others
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newstart_MO
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Dec 17, 2024 at 3:59 AM#5

Adding the clinical framing, because it changes how the question reads.

dosing arithmetic — critical reminder about tirzepatide dose equivalence across formulations:

Mounjaro KwikPen and compounded tirzepatide are the same molecule but:

  • KwikPen is ready to inject, no mixing needed
  • Compounded requires reconstitution and proper syringe technique
  • Verify your compounded concentration before each injection
  • Never assume 1 vial = 1 dose without checking the math
Last edited: Dec 17, 2024 at 9:59 AM
48 18RunnerRach, TrialNerd_Beth, HPLC_Greg and 45 others
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