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If oral bioavailability is low (1030%, similar to some quaternary ammonium compounds), a much higher oral dose would be required to match the plasma exposure achieved with subcutaneous injection

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Following any kind of intramuscular injection, it is possible for soreness, numbness, redness, itching, or bruising to develop at the injection site

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B vitamins are depleted under stress, and may also depleted if taking metformin and certain other medications