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Immediate medical attention is warranted if any of the following symptoms develop: Jaundice : yellowing of the skin or whites of the eyes, which may indicate significant liver dysfunction or bile duct obstruction Severe abdominal pain : particularly in the right upper quadrant or pain radiating to the back, which could suggest gallbladder problems, pancreatitis or other hepatobiliary complications Fever with abdominal pain : which may indicate cholecystitis (gallbladder inflammation) Dark urine accompanied by pale stools : suggesting impaired bile flow Unexplained bruising or bleeding : potentially indicating reduced synthesis of clotting factors by the liver For these symptoms, patients should contact NHS 111, seek same-day GP assessment, or attend A&E if symptoms are severe

For most standard two-day shipments in moderate weather, the ice packs melt partway through transit but the medication arrives within safe temperature ranges

Reconstitute with bacteriostatic water, adding the water slowly along the vial wall to avoid damaging the peptide

10.1016/j.pscychresns.2018.07.001 3

The absolute risk difference was an additional 27 (range 17-38) events per 100,000 patients per year

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