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[42] The EFSA also reviewed the safety question and reached the same conclusion as in the United Statesthat there was not sufficient evidence to set a UL for vitamin B 12
Substituting tirzepatide for semaglutide is a theoretical extension of that idea pairing an amylin analog with a more potent dual incretin agonist but it is important to repeat that this specific pairing has not been validated in a dedicated human combination trial
Patients should treat it as exploratory rather than established
Information for Patients: Patients with pernicious anemia should be informed that they will require monthly injections of vitamin B12 for the remainder of their lives
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