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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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Medication is billed separately in 12-week cycles

If you're on immunosuppressive medications (biologics, corticosteroids), discuss with your doctor before starting any peptide protocol