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People with known hypersensitivity to cobalt or cyanocobalamin should not use cyanocobalamin injection unless a clinician has evaluated the risk and chosen an appropriate plan

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It is particularly common in individuals with certain risk factors, including those who have undergone gastric or small intestine resections, have inflammatory bowel disease, use metformin or proton pump inhibitors, follow a vegan diet, or are older than 75 years
