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Refrigeration is a best practice to help maintain stability *within* the 28-day window, but it does not extend the expiration date

Ollman, Leah

This is due to the expiration of the 2.93% increase for 2024, as well as a small budget neutrality adjustment

A small percentage of users report sleep disturbances with evening dosing, possibly related to nitric oxide system effects

Cosentino M, Marino F

However, the current available antibody assay has low sensitivity and studies have found that antibodies are only detectable in 4060% of pernicious anaemia cases, so a negative test cannot categorically exclude pernicious anaemia[18,19]