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There are no other absolute contraindications reported for hydroxocobalamin use in deficiency states, but caution is advised in individuals with conditions such as early Lebers optic neuropathy (a rare hereditary optic atrophy) due to the theoretical risk of worsening vision
References View all 6 references + Pickart, L., & Margolina, A
An opened vial stays in the same 20 to 25C range
Conversely, populations in rural and underprivileged settings often lack such awareness, compounding their vulnerability
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