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Seek emergency care for trouble breathing, facial or throat swelling, fainting, severe rash, vision change, severe weakness, palpitations, or signs of injection-site infection

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This decyanation process is demanding: Although the amount of cyanide is considered toxicologically insignificant, humans must remove and detoxify the cyanide molecule, reduce the cobalamin to its usable +1 oxidation state, and then enzymatically convert the cobalamin into one of two metabolically active coenzyme forms