How to reconstitute a vial
Why it arrives as powder, the order of operations, and the arithmetic that decides what every later dose contains.
Why it arrives as powder
Peptides in solution degrade. Freeze-drying them — lyophilisation — removes the water and makes the compound stable for long periods at room temperature. The trade is that you have to add the liquid back yourself before it is usable.
You add bacteriostatic water, not sterile water. The difference is 0.9% benzyl alcohol, a preservative that inhibits bacterial growth and is what makes it safe to draw from the same vial repeatedly over days or weeks. Sterile water has no preservative and is single-use only.
The actual steps
Let the vial reach room temperature. Swab both stoppers with alcohol and let them dry. Draw your chosen volume of bacteriostatic water into the mixing syringe.
Insert the needle at an angle and let the water run down the inside wall of the vial. Do not squirt it directly onto the powder — the force can damage the peptide.
Swirl gently until dissolved. Never shake. Shaking denatures peptides, and a vial that has been shaken may look fine and be substantially less potent.
Write the date on the vial and refrigerate it. This sounds trivial and it is the step people most often skip and most often regret.
The arithmetic that matters
The volume of water you add determines the concentration, and therefore what every dose after it contains. Add 2 ml to a 10 mg vial and you have 5 mg per ml. Add 1 ml to the same vial and you have 10 mg per ml — meaning the same mark on your syringe now delivers double.
Insulin syringes are marked in units, not millilitres. On a standard U-100 syringe, 100 units is 1 ml. This unit conversion is where nearly every dosing error originates.
Our reconstitution kit includes a printed chart for the vial sizes we carry. Use it. Doing this arithmetic from memory at 6am is how mistakes happen.
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