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This was because hydroxocobalamin produced by bacteria was changed to cyanocobalamin during purification in activated charcoal columns after separation from the bacterial cultures (because cyanide is naturally present in activated charcoal)
These three injections per week occurred for four subsequent weeks
PubMed Benowitz NL, Osterloh J, Goldschlager N, et al
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Timing and market context The effective date is notable because it aligns with several market and regulatory developments including the January 1, 2027 implementation of the Medicare maximum fair price for these drugs
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