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[3] [8] Patients receiving B12 injections should inform their healthcare provider of all medications, as certain drugs (including metformin, proton pump inhibitors, and chloramphenicol) can affect B12 absorption or metabolism

Common adverse effects include: Injection site reactions pain, redness, swelling, or bruising at the intramuscular injection site Gastrointestinal disturbances nausea, diarrhoea, or abdominal discomfort Headache and dizziness particularly following initial doses Skin reactions including rash, pruritus, or acne-like eruptions Flushing temporary redness of the skin Chromaturia red-coloured urine (harmless but can cause concern if unexpected) Less common but more serious reactions include: Hypersensitivity reactions ranging from mild urticaria to anaphylaxis (rare but potentially life-threatening) Hypokalaemia particularly during initial treatment when rapid cell production occurs [5] [16] Temporary changes in blood counts during correction of deficiency Interference with laboratory tests primarily with high-dose IV hydroxocobalamin used for cyanide poisoning, not typically with standard 1mg IM replacement doses Cautions and contraindications: Hypersensitivity to cobalt or vitamin B12 Cyanocobalamin should be avoided in Leber's hereditary optic neuropathy [2] [17] Chloramphenicol may reduce the haematological response to B12 therapy Patients receiving B12 injections outside clinical necessity face unnecessary risks without proven benefit

Methylcobalamin is an active form of Vitamin B12

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hospitals and compounding pharmacies and is under restricted allocation due to the current product shortage