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WARNINGS: Patients with early Leber's disease (hereditary optic nerve atrophy) who were treated with cyanocobalamin suffered severe and swift optic atrophy

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2001 Most common overdose symptoms / injection-site erythema, transient headache, mild nausea IGF-1 elevation risk / not observed at doses up to 1 mg/day in Phase IIb data Emergency action / stop dosing, call Poison Control (1-800-222-1222), seek ER if chest pain or dyspnea occurs Antidote / none exists