Every time you puncture the vial's septum with a needle, you risk introducing airborne contaminants
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This may include men with diabetes, after prostate surgery, or those with more severe vascular ED
doi: 10.7326/0003-4819-141-11-200412070-00035 64
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[PMC free article: PMC3161301] [PubMed: 21775755] (Among 460 patients with diabetic polyneuropathy treated with ALA [600 mg] or placebo once daily for 4 years, there were no differences in the primary outcomes between the two treatment groups while severe adverse events were more frequent with ALA [38% vs 28%]