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But only one is designed for repeated access from the same vial

Could you use sterile water

doi:10.1016/j.clinbiochem.2003.08.004

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The metabolism and elimination of NAD+ (and its by-products) could be altered in advanced hepatic or renal dysfunction, and high-dose NAD+ might theoretically affect cardiovascular dynamics, so practitioners generally avoid or closely supervise NAD+ use in such settings