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Systemic inflammatory response syndrome (SIRS) following unregulated IV administration, presenting with fever above 41 degrees Celsius, acute liver injury, and clotting abnormalities, is also documented in a 2025 case report

Antacid drugs that neutralize stomach acid, as well as acid-suppressing agents such as proton-pump inhibitors, can inhibit the absorption of vitamin B 12 by preventing its release from food in the stomach