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These extremely rare side effects include: Reactive thrombocytosis during the first week of use in megaloblastic anaemia Hypersensitivity reactions including: rash, itching, exanthema, antibodies to HYDR0XOCOBALAMIN-transcobalamin II Anaphylaxis Hypokalaemia Headache, paraesthesia, tremor Irregular heartbeat (arrhythmias secondary to hypokalaemia) Nausea Vomiting Diarrhoea Fever, chills, hot flushes, dizziness, malaise, pain and / or swelling at the injection site Acne Abnormal colouration of the urine (chromaturia) B12 injections work quickly

Subnormal levels of gamma glutamyl transferase may be seen in cases of acute intrahepatic cholestasis, the use of certain medications, and in bone disease