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This product remains viable for up to two weeks at room temperature but is not shelf-stable and requires refrigeration for long-term storage
The mechanism appears to involve the nitric oxide (NO) system
1982 Oct;299(5884):58391
[10] Gastrointestinal disturbances-including nausea, loose stools, and a transient fishy body-odor attributable to trimethylamine production from excessive carnitine and choline metabolism-occur in a minority of recipients and are usually self-limiting within 24 to 48 hours after injection
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