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Theres also a possibility that the compounded drug has incorrect concentrations, which would mean the person is unknowingly under- or overdosing

Protein Sci (2016) 25(3):54658

Once reconstituted with bacteriostatic water, store at 2-8C and use within approximately 4 weeks

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They also noted that subjects in this study were either overweight, obese or had type 2 diabetes, the latter of which is an established risk factor of NAION, with others including heart disease, history of heart attack, high blood pressure and sleep apnea