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(iii) cardiovascular disturbances, chronic heart failure, pulmonary hypertension, and arrhythmias

Cases of progressive gait instability and loss of balance have been documented in patients taking extremely high doses for extended periods, with symptoms in some instances proving irreversible

Previous studies have reported inconsistent results when comparing oral, sublingual, and intramuscular administration, often limited by small sample sizes or heterogeneous populations (Vidal-Alaball et al., 2006