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This has been highlighted by the Australian Therapeutic Goods Administration (TGA), which has released a Medicines Safety Update with new warnings to be added to the product information of this class of drugs about risks during anaesthesia or deep sedation

It does not necessarily kill bacteria but prevents their growth, thus preserving the sterility of the water for a limited period after the vial has been accessed

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The primary risk is prolonged receptor downregulation requiring 1012 week washouts instead of the standard 68 weeks, with no meaningful anabolic gains past week 6 to justify the extended recovery time