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A compounded product that the prescriber documents as clinically significantly different from the commercial formulation is not treated as essentially a copy in the first place so the four-per-month threshold does not apply to those prescriptions

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For those at high risk, hydration plus rasburicase is recommended for prevention (Coiffier 2008)

L-Carnitine supplementation increases Trimethylamine-N-Oxide but not markers of atherosclerosis in healthy aged women

Numerous later studies have shown the association between increased plasma TMAO levels with a higher risk of cardiovascular events [6366]