WARNING USE OF THIS PRODUCT WITHOUT DIRECT SUPERVISION OF A PHYSICIAN IS DANGEROUS ; Some patients afflicted with pernicious anemia may or not respond to the orally ingested vitamin B 12 , and there is no known way to predict which patients may respond and which patients may cease to respond; Periodic examinations and laboratory studies of pernicious anemia patients are essential and recommended ; and - The parenteral administration of (cyano) cobalamin - or vitamin B12, is generally recognized as a fully effective treatment of pernicious anemia. Parenteral alkyl -cobalamin preparations have not been and are not authorized for use except by or on the prescription of a physician.
boxed warning table
<table cellspacing="0" cellpadding="0"><tbody><tr><td><list listType="ordered"><item><content styleCode="bold">USE OF THIS PRODUCT WITHOUT DIRECT SUPERVISION OF A PHYSICIAN IS DANGEROUS</content>;</item><item><content styleCode="italics">Some patients afflicted with pernicious anemia may or not respond to the orally ingested vitamin B</content><content styleCode="italics">12</content><content styleCode="italics">, and there is no known way to predict which patients may respond and which patients may cease to respond;</content></item><item><content styleCode="bold">Periodic examinations and laboratory studies of pernicious anemia patients are essential and recommended</content> ; and -</item><item><content>The parenteral administration of </content><content styleCode="italics">(cyano)</content><content>cobalamin - or vitamin B12, is generally recognized as a fully effective treatment of pernicious anemia. Parenteral </content><content styleCode="italics">alkyl</content><content>-cobalamin preparations have not been and are not authorized for use except by or on the prescription of a physician.</content></item></list></td></tr></tbody></table>
ADVERSE REACTIONS Mild transient diarrhea, polycythemia vera, itching, transitory exanthema, feeling of swelling of entire body may occur with administration of cobalamin. Allergic sensitization has been reported following both oral and parenteral administration of folate.