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Nascobal may be prescribed for individuals with: Pernicious anemia Post-gastric bypass or GI surgery Chronic atrophic gastritis B12 deficiency due to Crohns disease or other GI conditions Long-term use of metformin or acid-reducing medications Vegetarian or vegan diet with inadequate B12 intake It is not intended for use in those with nasal congestion or damage to nasal tissue unless otherwise advised by a healthcare provider

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Monitor patients for: Pills: Some patients may experience mild gastrointestinal discomfort