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Warnings and Precautions Hypokalemia: B12 therapy may cause a drop in potassium levels (hypokalemia), particularly during early treatment in patients with significant B12 deficiency

Allow to absorb - do not rinse

Concurrent administration of pyridoxine with these medications has been reported to lower their therapeutic levels, so monitoring and dosage adjustments of the anticonvulsant might be required if high-dose vitamin B is given

therefore we ask that you please provide us with a recent copy of lab work, which reflects liver and kidney function

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Summary: Elevated vitamin B12 levels rarely cause direct symptoms