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Impaired activity of methionine synthase results in elevated blood concentrations of homocysteine, while impaired activity of L-methylmalonyl-CoA mutase results in increased concentrations of a metabolite of methylmalonyl-CoA called methylmalonic acid (MMA) in blood and urine
Storing a vial on its side or inverted keeps the solution in sustained contact with the rubber stopper, which pharmaceutical literature describes as a potential leachable-contamination pathway over extended periods
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