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Activation of Mania/Hypomania Advise patients and their caregivers to observe for signs of activation of mania/hypomania and instruct them to report such symptoms to the healthcare provider [see Warnings and Precautions ( 5.7)]

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Pregnant or breastfeeding women who suspect B12 deficiency should have their levels tested by their prenatal care provider, who can recommend the appropriate supplementation route and dosage