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once reconstituted with bacteriostatic water, it requires refrigeration at 28C and should be used within 28 days

doi: 10.1542/peds.2011-1106 41 MeltzerD

Rare but serious risks include allergic reactions (including anaphylaxis in very rare cases), liver stress with prolonged high-dose use, and excessive skin lightening with unregulated dosing

Obesity and metabolic disease carry particular health burdens for men, including increased risk of type 2 diabetes, cardiovascular disease, obstructive sleep apnoea, and hypogonadism (low testosterone)

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