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FDA guidelines for reconstituted medications: Pharmacy standards for reconstituted injectable medications typically cite 28 days as maximum when using bacteriostatic water, even with refrigeration

This results in decreased autophagy and increased apoptosis, contributing to Schwann cell dysfunction

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These non-GI side effects are less well-characterized but commonly reported in community discussions, and a slower titration gives more time to determine whether they are transient adaptation effects or genuine intolerances