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Its important to keep an eye on B12 levels in patients with kidney failure

[10] [11] Intramuscular B12 injections (hydroxocobalamin or cyanocobalamin) bypass the digestive system, but UK product information (SmPCs) for hydroxocobalamin injections does list gastrointestinal disturbances, including diarrhoea, as possible adverse reactions, albeit rare

The medication should be transported in an insulated cooler with ice packs if refrigeration will not be available during travel, taking care to prevent direct contact with ice to avoid freezing

B-12 injections contain high levels of cyanocobalamin

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A clear suitability assessment before treatment