Sterility risks of adding air during vial reconstitution and transfers

No problems here at all. 31-gauge needles are slow. 30-gauge ones move better and it comes out like an IV drip. Right now my doses are tiny, under 3 mg. With a bigger dose I can see how adding air would help.

I do the same. Not everyone does, and I skip it when filtering into a fresh vial. I usually vent so there's no pressure. Adding air makes it easier to pull the liquid into the injection syringe. Even with a 31g needle the draw from the vial is already slow.

Well that is still putting air into the vial.

Posts like that are why I come here, yet they also make me wonder how I am still alive. I cannot do everything suggested, but I started capping the mixed vials and wiping the caps with alcohol swabs. The mask idea sounds good so I will try that. Now I need to find out about vent needles.

You follow the same steps I see in certain videos. That is solid. I already do many of the things you listed and keep a very clean space at home.

Most people skip all that and I have not seen reports of problems from it. Lowering risk is fine but this level feels excessive. It might fit someone with a weak immune system, otherwise it is more than I want. I know someone who goes all-in on everything and I tell him he overdoes it. This matches what he would do.

I hear from others who pin ten to fifteen times. They ought to hire a nurse. That leads to another talk about pens versus syringes. I prefer syringes for many reasons but plenty of people push me toward pens. We will see. There is something about using a short needle on my stomach that feels like paying for past habits. When offered junk food I picture the needle and say no.

Ask people who inject insulin daily how they handle it.

What are you saying? Explain the logic. Do you filter your material? Venting the new vial lets you push the mixed liquid in without pressure fighting back. The fresh vials I use start with no vacuum, so adding two or three milliliters makes the syringe push back.

Overdoing it would look like the setups used in hospital pharmacies for making injectable solutions. Your friend might want to buy one of those.

Exactly. My ex used to manage type 1 diabetes with multiple daily shots for over fifty years, many of them from multi-dose vials with standard syringes. New vial meant air went in first, then the dose came out. I watched it hundreds of times. People with that condition often reuse pen needles far longer than once per day and sometimes forget to swap them at all.

That is wild. Even apart from sterility, the idea of pushing the same needle back in a second time sounds painful. Pen needles included.

After half a lifetime maybe it stops bothering you, but after eight months I am still sensitive.

That was my point. I worked as a paramedic for years. The only medication we filtered was amiodarone, using a needle straw for it.

Good question. I cannot draw without adding some air. We also have good air quality and run a HEPA purifier indoors.

I will start filtering my peptides from now on.

I will too. A couple of pens are on the way along with filters, cartridges, and 3 ml luer-lock syringes. I am trying pens for the first time. Reta and KPV will be added to the weekly schedule for a bit and I want to see how pens work with more frequent injections instead of once a week.

Exactly. You have to rock the plunger back and forth to get every last bit out.

Do it. I never filtered until six vials ago. It does not add much time.

I used to skip adding air. On some vials I could actually see air bubbling in through an earlier puncture while drawing the next dose. Now I use pens, add air to the vial, then filter into the cartridge so the issue disappears. I mentioned this before when talking about that post on never swapping needles. A nurse with thirty-plus years said nobody outside this group changes needles for every personal shot. Your mileage may vary.

That does not sound right. Are you saying they draw and inject multiple times with the same needle?

You are describing a narrow case that does not match this thread. The original post was about adding air before drawing. Drawing a lot from a vial does create vacuum that can make pulling difficult or impossible. You either add air or vent. Either way air enters.

I think the point is that a fresh empty vial gets a filtered vent added first, so when liquid moves over from the original vial it just displaces the air already inside. No new air is being pushed in during that step. After the transfer the new vial should stay free of vacuum, so there would be no need to add air later when drawing doses.

At the start there is no vacuum, but once you start pulling doses out it will develop depending on how much volume you remove.

Right, the comment was about multi-use pens like the ones we see here, not about reusing a disposable diabetic syringe. On a side note I ran short on needles at my current posting so I have been reusing the one on my pen for multiple shots.

The part about cloudiness caught my attention. I have a couple of vials I have been using for three months and they still look fine, mostly the tirzep one. How long did it take before you saw clouding? Some people I know have gone six months on the same vial. The grey-market users seem to avoid the problem that hits the folks who paid extra for pre-mixed compounder vials.

My reta usually runs out around week eight and it has never clouded by then. Lower doses would probably let it last longer, but the compound is gone before any cloud shows up.

I accept that. Still some people argue that BAC only slows bacteria rather than stops it completely and that growth can still happen. I have no problem with adding air anyway.

The idea is to use the product right away rather than leaving air sitting in the vial for extended periods, and they are also taught from day one to expel any air from the syringe before injecting.