> ## Documentation Index
> Fetch the complete documentation index at: https://help.clinikehr.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Partial-vial dispensing

> Give 7.5 mg from a 125 mg vial and have the shelf read 117.5 mg — with the lot, the vial and the use-by date all kept straight.

<Availability editions={['clinic', 'pharmacy', 'lims']} plans="Essential and above · Professional and above on Pharmacy and Lab" roles="Any staff member who can administer medication" />

A weight-loss clinic buys tirzepatide in a 125 mg vial and gives it by the shot. A med spa draws 20 units of Botox from a 100-unit vial. A lab aliquots a reagent. In all three the vial is opened once and used many times, and the question at the end of the week is the same: **how much is actually left, in which vial, from which lot?**

Partial-vial dispensing answers it. Each vial is tracked as itself — what is left in it, when it was first punctured, when it must be thrown away, and which lot it came from.

## What it looks like

A patient has a 7.5 mg dose:

| Before                   | Action                   | After                                     |
| ------------------------ | ------------------------ | ----------------------------------------- |
| Vial #1 — 125 mg, sealed | Give 7.5 mg              | Vial #1 — **117.5 mg**, open, lot AB-1234 |
| Vial #1 — 117.5 mg, open | Next patient gets 2.5 mg | Vial #1 — **115 mg**, open                |
| Vial #2 — 125 mg, sealed | *(untouched)*            | Vial #2 — 125 mg, sealed                  |

The second dose went into the **already-open vial**, not a fresh one. That is deliberate: finishing an open vial before puncturing another is what stops a clinic throwing away half a vial every time a use-by date passes.

## Set up an item

<Steps>
  <Step title="Turn on fractional dispensing">
    Open the item in **Inventory → Items** and, under **Partial-vial dispensing**, turn on **Allow fractional dispensing**. Until you do, the item behaves exactly as before — whole units only.
  </Step>

  <Step title="Write the strength as it is printed">
    Under **Printed strength**, enter the pair the way the label reads it — **Amount** 125, **Unit** mg, **per mL** 12.5. Both halves matter. From them the dose screen works out that a 7.5 mg dose is **0.75 mL**, and **75 units** on a U-100 syringe — the number the person holding the syringe actually reads.
  </Step>

  <Step title="Say how much one vial holds">
    **One container holds** is the amount in a single container — 125. **Called a** is the name your team uses: vial, pen, ampoule, bottle.
  </Step>

  <Step title="Set the dose step and the use-by rule">
    **Dose increment** (e.g. 2.5) shapes the dose box and warns on an off-step amount. **Beyond-use days after opening** (e.g. 28) is stamped on a vial the first time it is punctured.
  </Step>

  <Step title="Decide whether a vial may be shared">
    **Single-patient container** binds a vial to the first patient it is drawn for and refuses anyone else. Leave it off for shared multi-dose vials, which is how most clinics run.
  </Step>

  <Step title="Price it per vial">
    Under **Pricing per vial**, enter the **Cost per vial** and the **Price per vial** — the figures you actually know. Each dose is charged its share of the vial: at 350.00 for a 125 mg vial, a 7.5 mg dose is 21.00 and a 24 mg dose is 67.20. The line underneath works it out as you type, with the cost and margin of one dose.

    A **Single-patient container** is sold whole instead — the patient buys the vial, which is theirs once it is opened — so it has a price per vial and no price per dose.
  </Step>
</Steps>

For an item priced per vial, the ordinary **Unit cost** and **Sale price** fields step aside, so the item has one price in one place.

## Receive vials

A vial item is received **as vials**, never as a bare amount. In **Receive stock** (or **Opening stock** when you add the item):

<Steps>
  <Step title="Say how many arrived">
    Enter the number of **Vials received**. **Each holds** is filled in from the item and can be changed for a delivery that came in a different size.
  </Step>

  <Step title="Enter the cost per vial">
    **Cost per vial** is what you paid for one. You can also change the **Price per vial** here — a new delivery is often when a price changes, and every dose from then on is charged its share of the new price.
  </Step>

  <Step title="Check the total and receive">
    The sheet reads back what goes into stock — "250 mg into stock as 2 vials — 400.00 at cost" — and what one dose will cost and sell for. Select **Receive**: the lot and each vial are created together.
  </Step>
</Steps>

What a dose costs is exactly its share of what the vial cost, so your cost of goods and margins are right to the milligram.

Stock that arrived before vials were used — or a lot you received as a plain amount — can still be divided afterwards: open the stock row's menu, choose **Vials**, then **Set up**. The system refuses to create vials that would claim more than the lot holds, and says by how much.

## Give a dose

For a vial item, **Dispense** becomes **Give a dose**. Choosing a vial item in the general **Dispense** sheet takes you there too.

<Steps>
  <Step title="Choose where from, and for whom">
    Choose the **Location** and the **Patient**. The patient is required for a **Single-patient container**, because that vial becomes theirs.
  </Step>

  <Step title="Type the dose">
    The line under the box reads back the dose, the volume and the syringe units — **7.5 mg · 0.75 mL · 75 units on a U-100 syringe** — and, for a shared vial, what this dose is charged and costs. If the item has no strength recorded, the volume is shown as a dash rather than a guess.
  </Step>

  <Step title="Choose the vial, or let it choose">
    **Open vial first, then earliest-expiring** is the default and is almost always what you want. You can pick a specific vial instead.
  </Step>

  <Step title="Give it">
    Select **Give dose**. Stock, the vial's remaining amount, the lot and the ledger all move together. A controlled item asks for a **Witness** first.
  </Step>
</Steps>

<Warning>
  If less could be drawn than you asked for, you get a warning naming the shortfall — **not** a success message. The syringe has less in it than the chart would otherwise claim, so check the remaining stock before giving that dose.
</Warning>

A vial is never drawn from once it is past its **use-by** date or its lot has expired. If every vial is in that state, the screen says so in those words rather than reporting "out of stock" — the drug is in the fridge, and it must not be used.

**Every** way stock leaves — a prescription filled from inventory, a ward dose, a till sale, a kit, a consumable used at an appointment — draws from the vials the same way, so the shelf and the vials can never disagree. Stock of the same item that is not in a vial is used only after the vials.

## Throw a vial away

When a vial is finished with while drug is still in it, use **Discard**. A **reason** is always required, and for a controlled item a **second staff member** must witness it. What was left is recorded as waste, so the shelf and the ledger still agree at the end of the month.

## Dose plans for GLP-1 and other step-ups

A patient on tirzepatide climbs a ladder — 2.5 mg, then 5, then 7.5, usually four weeks a step. Record that ladder once on the patient and the dose screen will propose the next dose and the date it is due, and flag it when today's dose skips a step or arrives early.

It **advises**; it never refuses. Holding a patient at 5 mg for tolerability is a clinical decision, and the chart follows the clinician.

## How many doses do I have left?

The item shows **doses**, not just milligrams: "47 doses at 7.5 mg", how many are **at risk** of passing their use-by date within the month, and how long your stock lasts at the rate you have actually been using it. A vial too empty for one more full dose counts as none — 3 mg left when the dose is 7.5 mg is not a third of a dose.

Where there is no usage history yet, days of cover shows a dash rather than zero.

## Who can do this

Giving a dose needs the same permission as any other medication administration. Receiving vials and setting them up need the permission that covers receiving stock. Both are set in **Settings → Staff permissions**.

## Common issues

<AccordionGroup>
  <Accordion title="“This item is not set up for partial-container dispensing”">
    **Allow fractional dispensing** is off for that item. Turn it on in **Inventory → Items**.
  </Accordion>

  <Accordion title="“The containers of lot … hold …, but only … of it would be left in stock here”">
    You tried to waste, move or adjust stock that is inside vials. Use **Give a dose** to draw from a vial, or **Discard** a vial with a reason — that way the vials and the shelf keep agreeing.
  </Accordion>

  <Accordion title="“Partial-vial dispensing is not included in the current plan”">
    The feature is on **Essential and above** (Professional and above on the Pharmacy and Lab editions). Vials already set up keep working if a plan changes — only setting up new ones stops.
  </Accordion>

  <Accordion title="“Every container of this item is past its beyond-use or expiry date”">
    There is stock, but none of it may be used. Discard those vials, with a reason, and set up the replacement.
  </Accordion>

  <Accordion title="“Every open container is assigned to another patient”">
    The item is set to **Single-patient container** and every open vial belongs to somebody else. Open a new vial, or turn that setting off if your clinic shares multi-dose vials.
  </Accordion>

  <Accordion title="The dose box will not take a decimal">
    Either the item does not allow partial dispensing, or the clinic's plan does not include it. Both are named in the message above the box.
  </Accordion>
</AccordionGroup>

## FAQ

<AccordionGroup>
  <Accordion title="Does the lot number stay attached to a part-used vial?">
    Yes. Every draw records the vial and its lot, so a part-used vial is always traceable to the batch it came from — which is what a recall needs.
  </Accordion>

  <Accordion title="Can I sell a part-dose at the till?">
    Yes. A shared vial's line starts at one dose, steps by the **Dose increment**, and is charged its share of the vial — the price reads "per mg" on the line and on the receipt. A **Single-patient container** is sold a whole vial at a time. Either way the sale draws from the same vials the chart does.
  </Accordion>

  <Accordion title="What happens to the leftover when a vial expires?">
    Discard it with a reason. The leftover is recorded as waste rather than quietly vanishing, so your counts still reconcile.
  </Accordion>

  <Accordion title="Can two people draw from the same vial at once?">
    They cannot take the same milligrams twice. A draw locks the vial for the moment it takes, so two tills cannot both take the last 2.5 mg.
  </Accordion>
</AccordionGroup>

For lots and expiry in depth see [Batches and expiry](/pharmacy/inventory/batches-and-expiry); for the rest of the module see [Inventory](/practice/ops/inventory).