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Although not inherently toxic, extended treatment with ASMswhich is common for patients suffering from a chronic disease like epilepsycan lead to the production and accumulation of toxic secondary metabolites inside the cells, leading to side effects like allergic reactions, cell death and organ damage in severe cases 6

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For patients without neurological involvement, the initial regimen is typically 1 mg intramuscularly three times weekly for 2 weeks

Treatment of vitamin B12 deficiency-Methylcobalamine

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