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[7] Commonly observed adverse effects include transient injection-site discomfort, breast tenderness, nausea, fluid retention, and mild mood fluctuation, whereas rarer but serious events encompass venous or arterial thromboembolism, gallbladder disease, significant elevation of blood pressure, and hormone-sensitive malignancies such as endometrial or breast cancer

However, exposure to air or contaminants may affect its quality over time

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Long-term metformin therapy and vitamin B12 deficiency: an association to bear in mind