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Pregnant or breastfeeding patients should discuss with their obstetric provider before starting this injection, and ensure all healthcare team members are aware, so that vitamin levels and any pregnancy-related effects can be monitored appropriately

Clinical findings might include possible pernicious anaemia or neuropathy including subacute combined degeneration of the cord

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The 8 to 12 week on / 4 to 8 week off pattern is extrapolated from pharmacological principles and community experience, not from controlled trials

Kocinaj A, Chaudhury T, Uddin MS, Junaid RR, Ramsden DB, Hondhamuni G, Klamt F, Parsons L, Parsons RB (2021) High Expression of nicotinamide N -Methyltransferase in patients with sporadic alzheimers disease