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[23] Cyanocobalamin is usually converted to hydroxocobalamin in the serum, whereas hydroxocobalamin is converted to either methylcobalamin or adenosylcobalamin

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Severe allergic reaction/anaphylaxis Symptoms may include: Difficulty breathing or swallowing Swelling of the face, lips, tongue, or throat Severe rash, itching, or hives Chest tightness or palpitations