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doi:10.1002/mabi.202100257 29

Thus, intranasal formulations should be carefully balanced with safety considerations and clinical success, rather than relying heavily on permeation enhancers to achieve effective, well-tolerated therapy (Qiu et al., 2025)

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In combined B12 and folate deficiency, B12 replacement must be started before folate supplementation to avoid precipitating or worsening neurological damage