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Medication and Supplements Check-up Interactions: There must be an interaction between the vitamins and other medications or supplements that you are using

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Vitamin Supplementation Initiate folic acid 400 mcg to 1,000 mcg orally once daily, beginning 7 days before the first dose of pemetrexed for injection and continuing until 21 days after the last dose of pemetrexed for injection [see Warnings and Precautions (5.1)]

In these cases, oral supplements may not be effectively absorbed, making B12 injections a more reliable treatment option