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After first use (first needle puncture), the vial should be used within 28 days

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Zhang Y, Calon F, Zhu C, Boado RJ, Pardridge WM

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They may include Minor rectal bleeding Severe pain during bowel movements Throbbing anal spasm/pain after bowel movements Small amounts of red blood on toilet paper or stool A lump or skin tag near the anal fissure Constipation Diagnosis Your doctor will most likely determine if you have anal fissures by performing a physical exam