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Regulatory Framework: Key FDA Guidance Documents for Nasal Sprays The foundation of nasal spray testing requirements in the United States is established by two primary FDA guidance documents, both from the Center for Drug Evaluation and Research (CDER): FDA CDER 2002 Nasal Spray and Inhalation Solution, Suspension and Spray Drug Products Chemistry, Manufacturing and Controls Documentation (CMC Guidance): Defines the CMC documentation requirements for new drug applications (NDAs) and abbreviated new drug applications (ANDAs) involving nasal spray and inhalation drug products

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If there is a lack of cobalamin in the body, methylmalonyl CoA accumulates, which presumably leads to the neurological manifestations of B12 deficiency.[4][7][9][12] The replenishment with parenteral cyanocobalamin causes a rapid and complete improvement of megaloblastic anemia and gastrointestinal symptoms caused by vitamin B12 deficiency