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Combined protocols (topical daily plus injectable 3 to 5 times per week) are common in aggressive skin and hair regimens

Metabolic Concerns: Potential for elevated blood glucose or increased insulin resistance with chronic, high-dose use, necessitating careful metabolic monitoring

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Patients typically begin with a lower starting dose (0.25 mg weekly for four weeks) to allow the body to adjust to the medication, reducing the likelihood of gastrointestinal side effects such as nausea or vomiting