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Both metformin and long-term use of proton pump inhibitors have been linked to reduced B12, and the same goes for many people past 50

Common side effects include changes in menstrual bleeding patterns, weight gain, acne, headache, and mood changes

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Official guidelines on missed doses (from Novo Nordisk) Novo Nordisk recommends the following for missed doses: If its been less than 2 days (48 hours) since your missed dose: Take the missed dose as soon as you remember

however, accumulation with chronic injectable use has not been characterized in long-term published studies

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