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unfortunately the vivitrol people have just come out with a new patient information guideline which informs patients of the risk of injection site reactions- it is available for review on their website and they sent me a beautiful color glossy on the importance of IM as opposed to subq injection.....the reactions do happen and can be very nasty and we wouldn't be doing our jobs if we didn't find a way of mentioning them...so now who is going to accept it??? sigh.
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