Its important to keep an eye on kidney function and B12 levels
PMID: 37111227
The metabolism and clearance of both components may be affected by significant liver disease, and patients with severe hepatic impairment should be monitored closely if treatment is deemed necessary
Unlike other forms of b12 like cyanocobalamin which is a synthesized product, methylcobalamin is a naturally occurring form found in animal-based foods

Common signs and symptoms include: Yellowish skin, known as jaundice Yellowish whites of the eyes, known as icterus Fatigue or fussiness Painful swelling of the hands and feet Frequent infections, especially pneumonia Fatigue and weakness Episodes of pain, called sickle cell crises, which occur when sickled red blood cells block blood flow to the limbs and organs Pernicious anemia may cause symptoms similar to other anemias as well as symptoms related to a vitamin B12 deficiency: Tingling and numbness in hands and feet Muscle weakness Loss of reflexes Loss of balance Trouble walking Weakened bones, leading to hip fractures Neurological problems, such as confusion, dementia, depression, and memory loss Nausea, vomiting, heartburn, abdominal bloating and gas, constipation or diarrhea, loss of appetite, and weight loss Enlarged liver Smooth, thick, red tongue Poor reflexes or unusual movements like face tremors Difficulty feeding due to tongue and throat problems Irritability Permanent growth problems if left untreated Anemia of chronic disease may cause similar signs and symptoms to other anemias, such as: Fatigue Pale skin Light-headedness Shortness of breath Rapid heartbeat Irritability Chest pain Causes and Risk Factors for Anemia While white blood cells fight infection, and platelets help your blood clot, red blood cells carry oxygen throughout your body

The medication is formulated in various strengths and vial sizes to accommodate physician determinations of patient need