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Moreover, it is of prime importance to consider the timings of the drug administration to the patients that may reduce the toxicity of the drug as tissue susceptibility to chemotherapeutic drugs are highly dependent on the chronotype of the patient (Montaruli et al., 2021)

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However, some potential considerations include mild injection site pain (B12 injections can sting slightly, though this is masked by the tirzepatide in the compound), rare allergic reactions in individuals with cobalt sensitivity, and the theoretical concern about cyanide accumulation in people with severe kidney disease who cannot efficiently excrete the trace cyanide released during cyanocobalamin metabolism

Neurosci Res 685 , e109e222 (2010)