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In SELECT, investigators were allowed to slow, decrease or pause treatment

[15] Serious but infrequent events-such as angioedema, bronchospasm, hypotension, or urticaria-reflect IgE-mediated hypersensitivity and may require desensitization or substitution with hydroxocobalamin

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But in most cases, people notice improvements after about three injections: Day 1 through Day 3: Most people feel better mood and increased energy Week 2 through Week 4: Better sleep quality