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NHS approach to B12 deficiency: NICE Clinical Knowledge Summaries recommend investigating B12 deficiency in patients presenting with macrocytic anaemia, unexplained neurological symptoms, or risk factors including pernicious anaemia, gastrectomy, malabsorption disorders, metformin use, proton pump inhibitors, or nitrous oxide exposure

A single accidental overdose is unlikely to be dangerous but will likely cause more severe nausea, vomiting, and possibly diarrhea

Sterile water for injection contains no preservative and must be discarded within approximately 24 hours of opening

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