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[16] Although cyanocobalamin lacks a defined upper-toxicity threshold due to its water solubility and renal elimination, exceptionally high cumulative doses have been temporally associated with acneiform eruptions, altered potassium homeostasis, and theoretical thrombotic risk, emphasizing the importance of evidence-based dosing

Use a 1-3 mL syringe with clear marks

Adult-onset acne most commonly occurs in patients in their early 20s and is rarer in patients over 50 years old (option b)

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