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How big are the needles

Administration Precautions: Before each administration, the vial should be inspected visually for any particulate matter or discoloration

Protection Against Stress-Induced Damage How it works: Chronic stress can harm the digestive tract and slow recovery

The medication should be transported in an insulated cooler with ice packs if refrigeration will not be available during travel, taking care to prevent direct contact with ice to avoid freezing

Since this 2012 publication, there has been very little new research into this question

If you see any of these visual cues, your research for that vial is over