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Hormonal shifts, especially during menopause, and metabolic disorders such as diabetes with autonomic neuropathy can reduce salivary output, and you should include endocrine evaluation where clinical context indicates

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You may also experience stomach bleeding if you suffer from stomach ulcers, take high doses of Ibuprofen, have liver disease, drink alcohol, or smoke

It can be kept at room temperature for up to 30 days before use

Gastroenterol Hepatol 2015 (2 ) 4: 00052