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Dispose of each syringe after its use by placing in a puncture proof container such as a coffee can or a sharps container to return to the clinic for disposal in a bio-waste container

A reticulocyte count may also be checked, as a rise in reticulocytes (young red blood cells) within the first week indicates effective bone marrow response

There is also recent data which suggest that genetic alterations of the receptor by which B12 is transported into nerve tissue and the brain, may lead to a lower B12 uptake

Commonly reported minor adverse effects include nausea, headache, somnolence (drowsiness), and mild paresthesia (tingling or numbness) in the extremities