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B12 is safe on its own, but a few conditions call for extra care, which is why a provider reviews your history before treatment: Leber's hereditary optic neuropathy, a rare inherited eye condition, where certain forms of B12 may be a concern for the optic nerve

The risk of precipitating the serotonin syndrome is increased if serotonergic drugs with different mechanisms of action are ingested, even weeks apart [182,183,184]

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Absorption happens through the oral mucosa and bypasses first-pass liver metabolism