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The MHRA recommends monitoring B12 levels in patients on long-term metformin treatment

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Using the wrong solution type is another frequent error: substituting tap water, saline, or an unverified liquid for pharmaceutical-grade bacteriostatic or sterile water introduces contamination risk regardless of how carefully everything else is handled

This can lead patients to incorrectly assume the medication isn't working, when the issue was storage-related potency loss

The most significant interaction involves other glucose-lowering drugs

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