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refrigerate after first puncture Discard 28 days after opening or per institutional guidelines Quality & Testing: Manufactured in ISO-certified, GMP-compliant facilities

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Regulators may consider the complete claims, presentation, intended purpose and pharmacological context

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Further, long-term use of acid-reducing drugs and the anti-diabetes drug metformin and repeated exposure to nitrous oxide have been implicated in vitamin B 12 deficiency (see Drug interactions)

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