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Contraindications include: Sulfa allergy, due to potential sensitivity to methionine derivatives

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These safety differences stem from AOD-9604s mechanism as a C-terminal fragment lacking affinity for the traditional growth hormone receptor

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[13] Chloramphenicol has been shown to blunt reticulocyte response to cyanocobalamin, while ethanol, colchicine, and nitrous oxide interfere with cobalamin metabolism or utilization, each warranting clinician awareness when evaluating suboptimal treatment outcomes