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However, to avoid possible adverse effects, it is recommended to start at 0.25 mg, which should be gradually increased over a period of 16 weeks

Absence of purging doesn't mean absence of efficacy

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A case report with light and electron microscopic studies

with other herbal agents or conventional therapies such as antihistamines and antibioticsmay enhance therapeutic outcomes and reduce recurrence rates

When you do restart, your surgeon may recommend beginning at a lower dose than you were taking, then titrating back up as your body adjusts