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Cyanocobalamin, vitamin B12 preparations containing benzyl alcohol should be avoided in premature neonates because benzyl alcohol has been associated with gasping syndrome, a potentially fatal condition characterized by metabolic acidosis and CNS, respiratory, circulatory, and renal dysfunction

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As this version of selenium contains sulfur, this may cause an adverse reaction in those with a CBS mutation and those who are sulfur-sensitive

In certain breeds, B12 deficiency in dogs can be genetically passed on, especially in beagles, border collies, and giant schnauzers