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Extended room temperature exposure of 24 hours or more means you should discard the vial

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Recalls & Warnings February 25, 2013 Nutrition Shake Recalled Due To Undeclared Allergen On February 22, 2013, Herbalife International of America issued a voluntary recall of certain lots of Instant Healthy Meal Nutritional Shake Mix packets which are labeled as dairy-free but may contain trace amounts of milk proteins

The shots are usually administered by a medical doctor or a dietitian in weight loss clinics or medical spas