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Hepatic cytochrome P450 isoenzymes CYP1A2 and CYP3A4 mediate N-de-ethylation, so polymorphisms or competitive inhibition at these pathways (e.g., by certain antidepressants or azole antifungals) may increase systemic exposure, underscoring the importance of individualizing dosage and monitoring serum concentrations in prolonged infusions

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Expected duration of vitamin B 12 deficiency With proper treatment, symptoms of vitamin B 12 deficiency begin to improve within a few days

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