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Pain relievers like acetaminophen or ibuprofen may be used if needed

[13] [9] Patients should report any changes in symptoms, particularly neurological manifestations, as these may indicate inadequate dosing or alternative diagnoses

10.1016/s0076-6879(10)72010-3 191 FerrieresG.CalzolariC.ManiJ

This impairment of DNA synthesis affects the rapidly dividing cells of the bone marrow earlier than other cells, resulting in the production of large, immature, hemoglobin-poor red blood cells (macrocytosis), as well as effects on white blood cells, including abnormal (hypersegmented) neutrophils and reduced overall cell counts (pancytopenia)