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Gastrointestinal Very common (10% or more): Gastrointestinal adverse reactions (up to 73%), nausea (up to 44%), vomiting (up to 36%), diarrhea (up to 30%), constipation (up to 24.2%), abdominal pain (up to 20%) Common (1% to 10%): Dyspepsia, abdominal distension, eructation, flatulence, gastroenteritis, gastroesophageal reflux disease, gastritis, viral gastroenteritis, increased amylase, increased lipase, dry mouth, severe gastrointestinal adverse reactions, delayed gastric emptying Uncommon (0.1% to 1%): Acute pancreatitis, appendicitis Frequency not reported : Hemorrhoids, hiccups Postmarketing reports : Ileus, intestinal obstruction, severe constipation, hiccups, acute pancreatitis, necrotizing pancreatitis In clinical trials in adults using the subcutaneous injection for weight reduction, 73% of treated patients reported gastrointestinal adverse reactions, including severe reactions (4.1%)

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Pharmacies with immunization services may also provide supervised B12 injections after an online consultation. At locations such as CVS MinuteClinic, licensed providers review your medical history, confirm that B12 injections are appropriate, and then administer the injection on site. This option can be convenient for patients who need ongoing injections and prefer easy access, extended hours, and transparent pricing

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Pull back plunger and draw back air to the 25 mark on the syringe (25 is halfway between the 20 and 30 mark on the syringe barrel)