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This legislation firmly states that virtually all medicines administered by injection are automatically designated as Prescription-Only Medicines (POM), creating a powerful legal hurdle that cannot be overcome by simply demonstrating safety through clinical trials alone

There is a low risk of serious side effects when administered by a qualified professional

Rarely, and almost exclusively from injections rather than oral supplements

Serious side effects are rare but may include allergic reactions, shortness of breath, and severe dizziness

Long-term supplementation with cyanocobalamin can have systemic toxic effects

However, complete symptom resolution, particularly for neurological complications, may take several weeks to months depending on the severity and duration of deficiency before treatment