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However, it cannot be legally imported without a special permit under the strict Special Access Scheme, which requires a doctor to apply to the TGA for permission to treat a particular patient with the drug, including describing the specific clinical need

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Cautious use of parenteral cyanocobalamin is also recommended in patients with renal impairment, including premature neonates, because of the possibility of greater aluminum accumulation, which may cause central nervous system and bone toxicity