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However, some potential considerations include mild injection site pain (B12 injections can sting slightly, though this is masked by the tirzepatide in the compound), rare allergic reactions in individuals with cobalt sensitivity, and the theoretical concern about cyanide accumulation in people with severe kidney disease who cannot efficiently excrete the trace cyanide released during cyanocobalamin metabolism

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[ Links ] Wang LN, Liu WB, Lu KL, Xu WN, Cai DS, Zhang CN, Qian Y