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However, community sources and pharmaceutical handling references consistently cite refrigeration at 2-8C as the documented best practice for punctured vials, for three reasons: Reduced microbial growth rate

That means 13 charges per calendar year, not 12, and advertised monthly prices understate the real annual cost by roughly 8%

Curr Probl Surg 2014

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Mittal notes, which is partly why it takes a while to notice the impact of missing a dose

This conceptual framework led to the hypothesis, now influential in clinical practice, that restoring a physiologic MI: DCI balance may outperform DCI monotherapy for reproductive endpoints (161)