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Low levels can cause depression and fatigue

FDA Pharmacy Compounding Advisory Committee meeting, July 23 to 24, 2026 (docket FDA-2025-N-6895)

I had a consultation with the neurology dept at the NIH

The post-opening discard period exists because: Sterility can no longer be fully guaranteed after first puncture Preservatives slow microbial growth but do not eliminate contamination risk Risk of contamination increases with repeated vial access For this reason, healthcare and laboratory settings typically follow a fixed discard timeframe (commonly 28 days), unless otherwise specified by the manufacturer