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Hydroxocobalamin in Neo-B12 Injection is the precursor for the enzyme co-enzyme B12 and this reacts with the enzyme Methylmalonyl Coenzyme A mutase, an isomerase required for the conversion of methylmalonate to succinate, an important step in production of lipoprotein in myelin sheath tissue, which could cause neurological problems

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The benzyl alcohol acts as a bacteriostatic agent, which means it doesn't necessarily kill all bacteria, but it prevents them from multiplying