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Hydroxocobalamin may also be given intravenously in certain scenarios (for example, 5 g IV for acute cyanide poisoning antidote therapy), but such high-dose use is in emergency settings and distinct from routine deficiency treatment
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[7] [9] Patients with a history of oxalate nephrolithiasis (kidney stones) or hyperoxaluria should avoid high-dose vitamin C administration, as ascorbic acid is metabolized to oxalate, which may precipitate stone formation or exacerbate renal impairment
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