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Mild side effects and potential risks, which should be referred to a doctor if they persist or worsen, include: pain, redness, or itching at the site of the injection mild diarrhea swelling sensation in the body More serious side effects, which require immediate medical attention, include: muscle cramps irregular heartbeat unusual weakness or tiredness swelling of the ankles or feet Severe reactions are very rare but require emergency intervention
PMID 20607069
The loading doses in the UK are 6 injections of 1mg/ml hydroxcobalamin ovef a 2 week period IM
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