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Though rare, there are some serious side effects that require immediate medical attention

Don't double up on doses to "catch up." If you frequently find yourself missing doses, it might be worth discussing with your healthcare provider whether your current schedule is realistic or if adjustments would be helpful

[21] Within cells, cyanocobalamin is converted to methylcobalamin and 5- deoxyadenosylcobalamin, coenzymes that participate respectively in homocysteine remethylation to methionine and in the isomerization of methylmalonyl-CoA to succinyl CoA, reactions essential for DNA synthesis, erythropoiesis, and myelin maintenance

You may feel some short-lived tenderness at the injection site, but most patients resume their normal routine immediately after this treatment