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Adverse Reactions/Side Effects The following important adverse reactions are described below and elsewhere in the labeling: Diabetic Ketoacidosis in Patients with Type 1 Diabetes Mellitus and Other Ketoacidosis [see Warnings and Precautions (5.1)] Volume Depletion [see Warnings and Precautions (5.2)] Genitourinary Infections, including Urosepsis, Pyelonephritis, Necrotizing Fasciitis of the Perineum (Fourniers Gangrene), and Genital Mycotic Infections [see Warnings and Precautions (5.3)] Hypoglycemia with Concomitant Use with Insulin and Insulin Secretagogues [see Warnings and Precautions (5.4)] 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice

They may also order blood tests to monitor factors like your blood sugar, kidney function, or other health markers to ensure the medication is not causing any unwanted effects

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Symptoms of vitamin B12 deficiency include

So it may be that the liver has to work extra hard to detoxify the body when its low 0on B12, even when there's no liver damage