Of note, the commercial Iscoves Modified Dulbeccos Medium (IMDM) and Serum Free Expansion Medium (SFEM), which were used as the basal medium for erythroblast cultures, contain a supraphysiological concentration of cystine at 292 M as compared to physiological plasma concentration of 4075 M cysteine in SCD patients, which decreased further to 3060 M during vaso-occlusive pain episodes 36
Potential side effects include gastrointestinal discomfort, such as bloating or diarrhea
The vial is supplied as lyophilized powder for manual reconstitution, while the pen version is pre-measured with an integrated click-dose mechanism
Before ordering from anyone, ask for the lot number and expiry date on the specific vial youd receive, ask which water standard was used in manufacturing, and ask whether the facility is a licensed pharmacy or an unregulated importer
But, the quantity of cyanide is considered to be clinically irrelevant
Symptoms develop gradually and may include: Hematological: Megaloblastic anemia, fatigue, weakness, pallor, shortness of breath, dizziness
