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Risks from Unregulated Use Quality Concerns : Without FDA regulation, quality can vary

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Beyond nausea, early dosing can worsen other GI symptoms

You could run into issues like: Compliance violations Patient safety problems Malpractice insurance coverage gaps Reputation damage Marketing and advertising claims risk Using restricted substances can even threaten your malpractice coverage

To keep track, its a good practice to write the date you mixed the solution directly on the vial

Here is a more detailed discussion: Gastrointestinal Upset Nausea and vomiting: A high dose of specific B vitamins, such as niacin causes gastrointestinal upset