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If you notice the stopper surface deteriorating or if the vial no longer holds vacuum (you don't hear a slight hiss when first puncturing), replace the vial or transfer contents to a fresh sealed container
Chang CC, Boland ED, Williams SK, et al

Refills and duration: Some prescriptions can be refilled multiple times (if the provider indicates refills on the prescription), especially for chronic conditions like hypertension or asthma

In preclinical research models, this interaction has been associated with changes in vascular tone and endothelial function parameters
