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Conversely, injecting when dehydrated increases blood viscosity and vascular fragilityadequate hydration 1-2 hours before injection supports vascular stability

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Individuals taking anticoagulant medications (such as warfarin, apixaban, or rivaroxaban) or antiplatelet agents (such as aspirin or clopidogrel) are at higher risk due to impaired clotting mechanisms

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Folic acid has also been shown to decrease vitamin B12 levels as well