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The NHS notes that taking up to 2,000 micrograms daily is unlikely to cause harm in most people, though there is generally no benefit to such excessive amounts without confirmed deficiency

Adequate studies in humans have not been conducted on parental methylcobalamin

[108] In addition, certain drugs may interfere with laboratory tests for the vitamin, such as amoxicillin, erythromycin, methotrexate and pyrimethamine

In practice, providers may advise against NAD+ injections in patients with serious underlying medical conditions as a precaution

This therapeutic strategy allows for the safe continuation of vitamin B12 therapy in patients who have previously experienced incidents of hypersensitivity to various forms of cobalamin, regardless of the route of administration and chemical form

Vitamin B12 is a co-factor in the transfer of methyl groups in the body, important in the synthesis of DNA