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Pre-dosing with 2550mg diphenhydramine (Benadryl) 30 minutes before injection blunts histamine-mediated flushing and reduces nausea by approximately 40% in clinical observation, though this adds drowsiness that may interfere with morning productivity
(fda.gov) Why the caution
Both serum potassium concentrations and the platelet count need to be monitored carefully after parenteral administration of cyanocobalamin
Vitamin C, Emulsifier: E 471
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