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Dilokthornsakul et al15 reported that most adverse events were gastrointestinal tract symptoms or skin reactions

Caba-Flores MD, et al

11-Hydroxysteroid Dehydrogenase Type 1 Inhibitors Previous studies have shown enhanced conversion of inactive cortisone to active cortisol through the expression of 11-hydroxysteroid dehydrogenase type 1 (11HSD1) in cultured omental adipose stromal cells (218)

They want to do it right with purity, with processing, and making sure that anything they make, especially a sterile compound, which is going to be anything injected, eye drops, things you inject in yourself, whether it's IV, sub-Q, or intramuscular, they're considered sterile