[DOI] [PMC free article] [PubMed] [Google Scholar] 48.Silveira SQ, et al
The authors wish to sincerely thank Yukiko Lema for assistance
Here are the clear discard triggers: Definite discard situations: Any visible cloudiness, particles, or color change beyond what is normal for your formulation Exposure to temperatures above 95 degrees Fahrenheit for more than 4 hours Any evidence of freezing (ice crystals seen at any point) Past the beyond-use date, even by one day Dropped and cracked vial, even if the liquid looks fine Known contamination (needle touch to non-sterile surface, etc.) Probable discard situations (consult your pharmacy): Extended exposure above 86 degrees for more than 24 hours Multiple repeated room temperature excursions totaling more than the stability window Delivery that sat in extreme heat or cold for an unknown duration Sudden loss of effectiveness with no other explanation Generally safe to continue: Single overnight exposure at normal room temperature (68-77F) Brief excursions of 1-2 hours during normal use Exposure to temperatures up to 77F for less than 14 days total Short car trips (under 30 minutes) in moderate weather When in doubt, contact your compounding pharmacy
According to the prescribing information, patients typically begin at 0.25 mg once weekly, then increase to 0.5 mg after four weeks
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