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While true allergies to methylcobalamin are exceptionally rare, any documented hypersensitivity to vitamin B12 preparations would contraindicate the use of this combination product

If you use the standard formulation, consider supplementing with B12 separately

Niacinamide (vitamin B3) supports metabolic function and has been studied for potential benefits in insulin sensitivity

[4] If you find yourself regularly unable to adhere to the weekly schedule, this should prompt a conversation with your healthcare provider about potential barriers to adherence, whether practical, psychological, or related to side effects that may be making you reluctant to continue treatment as prescribed

Ensure your medication is stored correctly and rotate injection sites weekly

This temporal relationship, whilst unlikely to be causal, helps clinicians build a complete clinical picture and exclude other potential causes requiring specific treatment