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While this is generally well-tolerated, it may be clinically significant in patients with certain pre-existing cardiac conditions

As a major intracellular antioxidant, it directly neutralises reactive oxygen species (ROS) and free radicals that accumulate during normal metabolism and are elevated in fatty liver disease

Any chest pain, heart palpitations, or cardiovascular symptoms

Most community protocols reconstitute the 80 mg vial with 3.0 mL bacteriostatic water (about 26.7 mg/mL total blend) and use once-daily subcutaneous injections starting at small volumes

So cardiologists will need to counsel patients through that and acclimate them to giving these drugs by subcutaneous injection. His colleague Dennis Bruemmer, MD, PhD, Director of Cleveland Clinics Center for Cardiometabolic Health, already has considerable experience using these drugs for diabetes and weight loss