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CDC summarizes USP guidance: date an opened multi-dose vial at first puncture and discard it within 28 days unless the manufacturer states another opened-vial date. The dose count and 28-day window together require three vials for the 12-week protocol

Ultimately, decisions on using bacteriostatic water during pregnancy or lactation should involve a risk-benefit assessment by the physician, and therapy should be monitored closely

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Hence, I position PDE5 inhibitors as symptomatic support while we work to restore the vascular and neural substrate

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