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Triamterene or hydrochlorothiazide-induced fluctuations in serum electrolyte concentration (including potassium loss in patients with hepatic cirrhosis) can occur and precipitate hepatic encephalopathy in susceptible patients

Drugs 30 (1), 511

Vials are vacuum sealed and stored in a temperature-controlled, monitored cold storage system

I have never come across an open-label study with small numbers of participants, using any treatment modality in fibromyalgia, that does not produce a similar positive result, from acupuncture to hands-on healing, Dr Lewis said

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Instead, they are just monitored by the FDA for adverse effects reported after the supplement is already available for purchase