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Like any injection, there is some discomfort during the injection but it is minimal
Topical effects Most reported topical effects are mild and local: redness, tingling, dryness, or transient irritation at the application site, typically more common with concentrations above 4%
Once in the circulation the ketones are taken up by non-hepatic tissues most likely by the plasma membrane localized monocarboxylate transporter 1 (MCT1)
Sterile water is suitable for patients of all ages , including neonates, making it the safer default option when patient sensitivity or age is a concern
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