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Dosing typically begins at a lower dose, suggested initiation of 4 units (0.04 mL) weekly for the first 4 weeks, then escalates according to a titration schedule: Weeks 1-4: Inject 4 units (0.04 mL) one time per week Weeks 5-8: Inject 8 units (0.08 mL) one time per week Weeks 9-12: Inject 18 units (0.18 mL) one time per week Weeks 13-16: Inject 30 units (0.3 mL) one time per week Week 16+: Inject 44 units (0.44 mL) one time per week Dosing may deviate from this pattern to accommodate patient-specific needs

Reactions that get worse over the first week, spread, or hurt sharply are a reason to pause and consult a clinician

Synergy is postulated but is not clinically proven for this specific combination

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