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After initiation and dose increases, patients should be observed carefully for signs and symptoms of pancreatitis (including persistent severe abdominal pain, sometimes radiating to the back and which may or may not be accompanied by vomiting)

[17] Use in food [edit] Cyanocobalamin is added as an ingredient to fortify nutrition in products such as baby formula, breakfast cereals and energy drinks as well as livestock feed

Studies indicate possible nootropic effects through enhanced cellular energy metabolism, improved mitochondrial function, and reduced oxidative stress

The injection Hydroxocobalamin is given as an intramuscular injection (into a muscle), typically by a trained healthcare professional