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Because air and possible bacteria can enter the vial, safety guidelines recommend using multi-dose vials within about 28 days after the first puncture

doi: 10.5935/1518-0557.20180003

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According to the company's compounded semaglutide page, "Ivm only selects FDA-inspected, state-regulated compounding pharmacies that meet regulatory board standards for quality and safety." Inspection of a pharmacy does not mean the compounded finished product itself is FDA-approved