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[16] Although cyanocobalamin lacks a defined upper-toxicity threshold due to its water solubility and renal elimination, exceptionally high cumulative doses have been temporally associated with acneiform eruptions, altered potassium homeostasis, and theoretical thrombotic risk, emphasizing the importance of evidence-based dosing

Patients can continue on topical therapy alone

Systematic review: short-term adverse effects of 5-aminosalicylic acid agents in the treatment of ulcerative colitis