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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

The study population characteristics were: median age of 64 years (range: 34 to 84), 49% age 65 years or older, 59% male, 94% White and 3% Asian, and 18% with history of brain metastases at baseline

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Sato Y, Honda Y, Iwamoto J, Kanoko T, Satoh K

Hyeon-Cheol Lee-Okada and Takehiko Yokomizo, Juntendo University