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All reported effects come from cell-culture and animal models and do not describe human outcomes

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Increases in alanine transaminase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) serum levels at moderate levels have also been reported among populations residing above 2,500 m and among low-altitude residents after climbing high altitudes 11,12

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Lyophilized (freeze-dried) vials contain peptide powder that must be reconstituted with bacteriostatic water before usethese are stable at 20C for 1224 months before reconstitution

as to whether it is truly the best treatment for melasma (as it is currently been marketed as)- we will have to await more studies