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Following the dose escalation schedule outlined in the SmPC is important for minimising side effects

Patients typically report improvements in sleep quality and recovery within the first two to three weeks

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An in vitro study (Teixeira and Rumjanek, 2014) showed that human monocytes treated with ouabain at a concentration of 100 nM produced heightened levels of early markers of monocyte activation: IL-1, TNF-, IL-10, vascular endothelial growth factor (VEGF), surface monocyte activation markers such as CD69, a transmembrane type II C-lectin receptor, and HLA-DR (Human Leukocyte AntigenDR isotype) (Ziegler et al., 1994)

Cortisone injections have become less in vogue medically due to their harmful side effects, including loss of muscle tissue, damage to ligaments and tendons, and bone loss