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ForumsCompounding & FormulationJust did my first reconstitution and I think I messed up — 6 month update Page 2

Just did my first reconstitution and I think I messed up — 6 month update

Dr.RenalNash Thu, Feb 22, 2024 at 4:05 AM 13 replies 2,050 viewsPage 2 of 3
DanielChem_CHI
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Mar 2024
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Feb 22, 2024 at 9:30 PM#6
KevinCompounds said:
Dead space is the answer to the missing dose.

I am going to disagree with reconstituting low as a general rule. More diluent, more punctures, more in-use days at room temperature, and the stability trade-off is real. Precision is not the only variable being optimised.

31 9fiona_VT, denise_HTX, raj_cambridge and 28 others
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lisa_labSD
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Oct 2024
San Diego, CA
Feb 23, 2024 at 4:24 AM#7
Dr.RenalNash 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…

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
32 10maya_sedona, stefan_berlin, Dr.EM_Chicago and 29 others
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EndoResFellow
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Sep 2024
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Feb 23, 2024 at 11:18 AM#8
DanielChem_CHI said:
I am going to disagree with reconstituting low as a general rule.

Sharing my dosing arithmetic titration experience with compounded semaglutide — I have been tracking injection volumes meticulously:

Using 5mg/2mL concentration with 1cc insulin syringes:

  • Month 1: 10 units (0.25mg) — mild appetite reduction
  • Month 2: 20 units (0.5mg) — significant appetite suppression
  • Month 3: 30 units (0.75mg) — custom intermediate dose
  • Month 4: 40 units (1.0mg) — optimal for me, staying here

The beauty of compounded vials is you can do custom intermediate doses. My provider was great about tailoring to my response.

33 11paul_denver, TinaHashiRN, robert_kc and 30 others
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nick_newbie
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Feb 23, 2024 at 6:12 PM#9

One thing that is still open after denise_HTX’s answer:

How to check the arithmetic without trusting a website calculator, since three calculators gave me three answers?

34 12LarryQC_SD, wanda_boise, NurseAsh_DET and 31 others
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Dr.RenalNash
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Nashville, TN
Feb 25, 2024 at 3:18 AM#10

OP back with an update, since a thread like this is useless without one.

Resolved. I wrote mg, ml and mg/ml on the vial in marker and did the division in that order, and the two of us now get the same number every time.

44 17maria_elpaso, anders_CPH, Dr.NutriCornell and 41 others
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