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Safety and Side Effects of Methylcobalamin and Adenosylcobalamin Side Effects and Safety Common Side Effects (mild to moderate) : Mild headache Nausea or upset stomach Skin rash or itching Rare Side Effects (moderate to severe) : Anxiety or nervousness Chest pain or shortness of breath Hypersensitivity reactions (e.g., swelling, severe rash) Safety Summary : Methylcobalamin is generally well-tolerated when taken as directed