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Cyanocobalamin should, if possible, not be given to patients with suspected Vitamin B12 deficiency without first confirming the diagnosis. Regular monitoring of the blood is advisable. Use of doses greater that 10 micrograms daily may produce a hematological response in patients with folate deficiency; indiscriminate use may mask the precise diagnosis.
Cyanocobalamin should not be used for Leber's disease or tobacco amblyopia since this optic neuropathies may degenerate further.
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