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Methylcobalamin, vitamin B12 preparations containing benzyl alcohol should be avoided in premature neonates because benzyl alcohol has been associated with gasping syndrome, a potentially fatal condition characterized by metabolic acidosis and CNS, respiratory, circulatory, and renal dysfunction

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As with all supplements, there is high and low quality

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However, it did not provide comprehensive insights into the pharmacokinetics and effects on vitamin B12 and related biomarkers after repeated intranasal administration