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One pivotal trial followed patients taking 600mg of racemic ALA daily for four years and found no significant safety concerns.7 We explore the differences between racemic ALA and R-ALA later in the guide, but its worth noting here: racemic ALA has the strongest long-term safety data in humans

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Voriconazole, the second line of treatment, can cause hepatotoxicity with its prolonged use [44]

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