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Johns Wort can accelerate clearance and diminish efficacy, whereas inhibitors like ketoconazole, clarithromycin, certain protease inhibitors, or excessive grapefruit intake may elevate serum estradiol and increase adverse-event risk
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Clean the injection site with alcohol, allow to dry, pinch the skin lightly if needed, insert the needle at a 45 to 90 degree angle depending on tissue depth, and inject slowly
This can occur in people who have certain medical conditions or who are on certain medications
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