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doi:10.1016/j.amsu.2020.11.010

Adverse reactions reported following methylcobalamin administration include headache, infection, nausea/vomiting, paresthesias, and rhinitis

The majority of reports of nausea, vomiting, and/or diarrhea occurred during dose escalation

During the course of the study, there was no change to the therapeutic regime other than the introduction of parenteral cobalamin supplementation