Pemmaraju N, Kantarjian HM, Ravandi F, Garcia-Manero G, Borthakur G, Parikh SA, Konopleva M, Kornblau SM, Andreeff M , O'Brien S, Cortes J
4 After the remaining intestinal arginine is absorbed into the blood, there are more enzymes that rapidly degrade it into a variety of metabolites including ornithine, creatine, proline, glutamine, and various polyamines

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Every minute outside the refrigerator counts toward that total, whether it is five minutes for an injection or five hours because you left it on the counter