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Swelling of the face, lips, tongue, or throat , trouble breathing or swallowing, a severe rash, or a racing heartbeat, which can signal a severe allergic reaction

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She did report a past history of one depressive episode about five years ago and stopped antidepressants after one year of treatment

This supports the potential of compounded cyanocobalamin/SNAC as a practical alternative for patients who are injection/needle-averse , non-compliant with injections, or seeking a more convenient therapy even if their providers have traditionally used methylcobalamin in injectable form