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Cyanocobalamin acts as a precursor for the bioactive forms of vitamin B12, methylcobalamin, and adenosylcobalamin, which are critical co-factors in DNA synthesis and red blood cell production

Antibiotic medicines such as chloramphenicol: Concurrent use may interfere with the haematologic response to vitamin B12 therapy and reduce its effectiveness in treating anaemia

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These adverse outcomes were attributed to the serotonergic properties of fenfluramine, leading to its market withdrawal in 1997