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If the vial was at room temperature for 1 to 7 days: it is probably still usable, but subtract those days from the 21-day room temperature maximum

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The risk of atherosclerotic disease was strongly associated with elevated homocysteine levels

Circulation 2001;103:2668-73.ArticlePubMed 33

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BMI Reduction: Adolescents treated with semaglutide achieved a mean BMI reduction of 16.1%, compared with a 0.6% reduction in the placebo group