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Two degradation pathways matter: Hydrolysis: Water cleaves peptide bonds, particularly at aspartate-proline sequences, which are among the most hydrolysis-prone linkages in peptide chemistry

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The four most common adverse effects reported in these studies were injection-site erythema, pruritus, urticaria, and rash

The FDA has also quantified the damage from the adjacent, better-studied compounds, and the numbers are a floor, not a ceiling

For others, it can be quite debilitating

But staying the course requires strategy