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Although generally safe, injections should be used with caution in people with a history of allergic reactions to cobalamin or in people with Leber's disease (hereditary optic neuropathy), as B12 may worsen the condition

These symptoms are usually short-lived and should subside within a few hours

"Role of hydroxocobalamin in acute cyanide poisoning" (PDF)

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The test has the following limitations: Levels of B 12 do not correlate well with clinical symptoms