People with pernicious anemia or significant gastrointestinal absorption issues may be placed on injections for this reason
peptide is hygroscopic
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[13] Chloramphenicol has been shown to blunt reticulocyte response to cyanocobalamin, while ethanol, colchicine, and nitrous oxide interfere with cobalamin metabolism or utilization, each warranting clinician awareness when evaluating suboptimal treatment outcomes
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Here's how: Withdraw 100 units (1ml) of mixing solution after wiping the vial top again with an alcohol swab
