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It contains a cyano (cyanide) group in its structure, which makes it more stable than other forms of vitamin B12 as the cyanide stabilizes the molecule from deterioration

This is generally not a cause for concern, but it can change how quickly medication takes effect in some cases

Some patients find that IV hydration therapy helps manage the dehydration and fatigue that can accompany the early adjustment period, particularly if nausea makes oral hydration challenging

This central mechanism means it targets the psychological component of sexual function desire and motivation rather than just the physical response

Most cases can be managed conservatively without discontinuing the medication