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Pyridoxine (B) in high doses is known to interact with certain drugs: it can reduce the therapeutic efficacy of levodopa by increasing peripheral conversion of levodopa to dopamine (vitamin B speeds up decarboxylation)

For patients with severe kidney disease, impaired renal function can affect how excess B12 is cleared from the body

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Freezing a mixed multi-use vial can create solution changes and freeze-thaw stress that are not worth accepting unless a protocol specifically requires aliquoted frozen storage