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Finally, if the serum cobalamin concentration at the time of reevaluation is subnormal, further work-up is required to definitively diagnose the underlying disease process and cobalamin supplementation should be continued weekly or bi-weekly (for parenteral supplementation) or daily (for oral supplementation)

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Any significant discoloration, particulate matter, or opacity in FDA-approved tirzepatide indicates potential degradation or contamination and the product should not be used