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Neomycin, colchicine, para-aminosalicylic acid, or excessive alcohol intake longer than two weeks may cause malabsorption of vitamin B12. Chloramphenicol and other drugs having bone marrow suppressant properties may cause a lack of therapeutic response to vitamin B12

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Animal-to-human amount translation is not straightforward and requires allometric scaling, and human pharmacokinetics, safety, and efficacy remain uncharacterized in published literature

Yet, patients with certain medical conditions should be evaluated before receiving treatment