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I do EOD of methyl b12 and take multi b vitamins thought out the day every day and a liquid sublingual b12 every day

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More than 72 hours at room temperature warrants discarding the solution

Therefore, consider reduced dosing and increased monitoring for local anesthetic systemic toxicity in patients with moderate to severe hepatic impairment treated with MARCAINE SPINAL [see Warnings and Precautions (5.10)]