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This is done because the vial is a vacuum, and you need to add an equal amount of air to regulate the pressure, making it easier to draw the medication into the syringe

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Although risen from a single common ancestor, their substrate specificity and diversity have been reshaped by gene duplication, genetic recombination, and an accumulation of mutations

Ocrelizumab versus Interferon Beta-1a in Relapsing Multiple Sclerosis

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In a head-to-head comparison trial pitting ALCAR against carnitine, only ALCAR reduced several biomarkers of oxidative stress within the brain, including those for lipid peroxidation, DNA oxidation, and protein oxidation [21]