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Opened vials get 28 days from the first puncture, and that date can never run past the printed expiry
Additionally, injections can be given twice a week if deemed appropriate
Instead, let it rest and heal naturally
[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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