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Using sterile water for injection (without preservative) means your multi-dose vial has no protection against bacterial growth after the first needle puncture

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Priya Jaisinghani, an endocrinologist who works in obesity medicine at NYU Langone Health

Nutrients 13 (7), 2228

[Google Scholar] 11.Zunz E & Barre JL Contributions ltude des variations physiologiques de la scrtion interne du pancras

[0007] WO2007/0611434 described pharmaceutical compositions of intranasal exenatide using similar formulation technologies in WO2007/146488, plus a dipeptidyl aminopeptidase (DPP) IV inhibitor to minimize enzymatic degradation of exenatide