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Serious but rare side effects include pancreatitis (severe abdominal pain radiating to the back), gallbladder problems (upper right abdominal pain, especially after eating), kidney problems (usually related to severe dehydration), severe allergic reactions (difficulty breathing, severe rash, facial swelling), and vision changes (particularly in people with diabetes)

Expect aggressive FDA enforcement against pharmacies that continue large-scale compounding post-shortage without documented patient-specific justifications

Other benefits, like more significant changes in fine lines or hair growth, typically take longer, often 2-3 months or more of consistent use

Proc Natl Acad Sci USA 1990