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These extremely rare side effects include: Reactive thrombocytosis during the first week of use in megaloblastic anaemia Hypersensitivity reactions including: rash, itching, exanthema, antibodies to HYDR0XOCOBALAMIN-transcobalamin II Anaphylaxis Hypokalaemia Headache, paraesthesia, tremor Irregular heartbeat (arrhythmias secondary to hypokalaemia) Nausea Vomiting Diarrhoea Fever, chills, hot flushes, dizziness, malaise, pain and / or swelling at the injection site Acne Abnormal colouration of the urine (chromaturia) B12 injections work quickly

However, repeated temperature excursions are the real problem

PMID: 38205450 19 Megaloblastic Anemias: Nutritional and Other Causes

Work quickly but carefully to minimize room-temperature exposure

This has become a relatively hot topic recently and one that many people may be too quick to jump to