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Do not take extra medicine to make up for a missed dose. This medicine is not right for everyone. Your doctor will check your progress and the effects of this medicine at regular visits. It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant. Tell your doctor if you are breastfeeding, or if you have kidney disease, diabetes, glaucoma, congestive heart failure, heart or blood vessel disease, high blood pressure, overactive thyroid, or a history of stroke or drug abuse.

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These include serious infection, uremia or renal failure, drugs with bone marrow suppression properties e. The mechanism appears to be interference with erythropoiesis. Patients with vitamin B12 deficiency and concurrent renal or hepatic disease may require increased doses or more frequent administration of methylcobalamin. Generally, dose selection for elderly patients should be done with caution. Elderly patients tend to have a greater frequency of decreased hepatic, renal, or cardiac function, and also have concomitant disease or receiving other drug therapy.

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