This product may contain inactive ingredients, which can cause allergic reactions or other problems. May be used to improve blood sugar control (also called glycemic control) in people with type 2 diabetes alongside diet modification and increased exercise. Carcinogenesis, Mutagenesis, Impairment of Fertility: Long term studies in animals to evaluate carcinogenic potential have not been done. Patients receiving Ozempic in combination with an insulin secretagogue (eg, sulfonylurea) or insulin may have an increased risk of hypoglycemia, including severe hypoglycemia. If you have a caretaker or a family member who is willing to administer your injection, this may be beneficial. Patients following such a diet, should be advised to take oral vitamin B 12 regularly. Indiscriminate administration may mask the true diagnosis. Available in packages of ten (N 0071-4259-03). It occurs as a white, crystalline powder, is freely soluble in water and alcohol and has a molecular weight of 291.82. The liver is the main organ for vitamin B12 storage. Atropine-like signs and symptoms; dry mouth; fixed, dilated pupils; flushing; and gastrointestinal symptoms may also occur. Read all information given to you. This is not a complete list of possible side effects. Oral absorption is considered too undependable to rely on in patients with pernicious anemia or other conditions resulting in malabsorption of vitamin B12. The injection is given once a week, on the same day each week (for example, every Monday). 10 to 50 mg intravenously at a rate generally not exceeding 25 mg/min, or deep intramuscularly, 100 mg if required; maximum daily dosage is 400 mg. Benadryl in parenteral form is supplied as: Benadryl Steri-Vials All other trademarks, registered or unregistered, are the property of their respective owners. If you need to store Neo-B12 Injection, keep it in the original pack until it is time for it to be given. Antihistamine overdosage reactions may vary from central nervous system depression to stimulation. Dickinson is a certified personal trainer with American Fitness Professionals and Associates. Patients can connect with a Diabetes Health Coach who can help answer questions about their prescription, diet, and exercise. Dodex Injectable (Cyanocobalamin Injection, USP 1,000 mcg/mL) is supplied as follows: NDC 16729-533-63 1 mL Multiple Dose Vial Boxes of 1, NDC 16729-533-08 1 mL Multiple Dose Vial Boxes of 25, NDC 16729-533-03 10 mL Multiple Dose Vial Boxes of 1, NDC 16729-533-10 30 mL Multiple Dose Vial Boxes of 1. Pain/redness at the injection site, mild diarrhea, itching, or a feeling of swelling all over the body may occur. Vitamin B12 is commonly found in many foods from animals, especially liver, kidney, fish and shellfish, meat, and dairy foods. ReviewA1Candweightresults from the Ozempicstudies for additional information and seethePrescribing Information. Hypoglycemia (low blood sugar levels), nausea, vomiting, diarrhea, abdominal pain, and constipation are commonly reported side effects. Benadryl (diphenhydramine hydrochloride) is an antihistamine drug having the chemical name 2-(Diphenylmethoxy)-N,N-dimethylethylamine hydrochloride. Cookie Policy If this occurs, semaglutide should be discontinued and not restarted. The dosage of semaglutide does not need to be adjusted in people with kidney or liver disease. Folic acid should be administered concomitantly if needed. It doesn't need to be refrigerated. sterile, pyrogen-free solution containing 50 mg diphenhydramine hydrochloride in a 1-mL ampoule. For preparation of the skin prior to injection. ACCIDENTAL OVERDOSE, SEEK PROFESSIONAL Each mL contains 1000 mcg cyanocobalamin. 2005 - 2023 WebMD LLC, an Internet Brands company. To notice peak impact, you may require two to three injections over several weeks for mild deficiencies. Keep the pen cap on when not in use. People who have a rare blood disorder (polycythemia vera) may rarely have symptoms related to this disorder while taking cyanocobalamin. https://www.drugs.com/monograph/semaglutide.html. Does injectable vitamin B12 need to be refrigerated? Starting March 2023, the red-labelOzempicPen that delivers 0.25 mg and 0.5 mgdoses has been updated. OUT OF THE REACH OF CHILDREN. CENTER IMMEDIATELY. Who should not take Cyanocobalamin (Vit B-12) 1,000 Mcg/Ml Injection Solution? WARNING: KEEP THIS AND ALL MEDICATION The most frequent adverse reactions are underscored. Rx Pharma Pack HAUPPAUGE, NY 11788. She also holds a Master of Arts in English from the University of North Florida, where she serves as a professor of rhetoric. Report any symptoms of a possible thyroid tumor (such as a lump in the neck, shortness of breath, difficulty swallowing, or persistent hoarseness) to your doctor immediately. Non-US Health Care Professionals, please go towww.novonordiskpro.com. Last updated on Sep 21, 2022. If folate levels are low, folic acid should also be administered. Semaglutide Injection: MedlinePlus Drug Information All rights reserved. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Failure to do so will result in return of the anemia and in development of incapacitating and irreversible damage to the nerves of the spinal cord. Copyright 1996-2023 Drugs.com. After Semaglutide administration the insulin secretion rate in people with type 2 diabetes was similar to that of healthy people. A pink frothy sputum can be produced by coughing. Tell your doctor if you inadvertently become pregnant while taking semaglutide. The oral form is not dependable. The most common adverse reactions, reported in 5% of patients treated with Ozempicare nausea, vomiting, diarrhea, abdominal pain, and constipation.1. Patients taking diphenhydramine hydrochloride should be advised that this drug may cause drowsiness and has an additive effect with alcohol. Protect yourself from the sun. WebMD does not provide medical advice, diagnosis or treatment. Effective at reducing blood glucose levels and it also reduces body weight. Cyanocobalamin Injection, USP is also suitable for the vitamin B 12 absorption test ( Schilling test). Repeat determinations of iron and folic acid may reveal a complicating illness that might inhibit the response of the marrow. Never mix insulin with semaglutide and never share your injection with another person. Cyanocobalamin Injection, USP 1000 mcg/mL, NDC 0517-0031-25 1 mL Fill in a 2 mL Vial Boxes of 25, NDC 0517-0032-25 10 mL Multiple Dose Vial Boxes of 25, NDC 0517-0130-01 30 mL Multiple Dose Vial Boxes of 1. A windbreaker is a lightweight jacket that protects you from the elements. How many pens per box? Keep it where children cannot reach it. Benadryl Injection Prescribing Information. Liquid formulas are light-sensitive, which is why they are usually packaged in opaque bottles. Cyanocobalamin is indicated for vitamin B12 deficiencies due to malabsorption which may be associated with the following conditions: It may be possible to treat the underlying disease by surgical correction of anatomic lesions leading to small bowel bacterial overgrowth, expulsion of fish tapeworm, discontinuation of drugs leading to vitamin malabsorption (see DRUG INTERACTION), use of a gluten-free diet in nontropical sprue, or administration of antibiotics in tropical sprue. If you need to store Neo-B12 Injection, keep it in the original pack until it is time for it to be given. sterile, pyrogen-free solution containing 50 mg diphenhydramine hydrochloride in each milliliter of solution. NDC 49836-527-01, MANUFACTURED BY: SCHMIGS Things to remember when you fill your prescription. Based in Jacksonville Beach, Fla., Laurie Dickinson began writing in 1977. Patients with Normal Intestinal Absorption: Where the oral route is not deemed adequate, initial treatment similar to that for patients with pernicious anemia may be indicated depending on the severity of the deficiency. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Learn about the safety profile for Ozempic. Because of the high levels of omega-3, fish oil supplements can reduce cholesterol and possibly reduce inflammation. Given orally or by injection under the skin (subcutaneously), once a week. How to Store Methylcobalamin Injection. Cooking doesn't destroy it. If there is clinical improvement and if a reticulocyte response is observed, the same amount may be given on alternate days for seven doses, then every 3 to 4 days for another 2 to 3 weeks. Also available as a once-weekly prefilled injection pen that is given subcutaneously (under the skin) (Ozempic brand). A portion of the drug is excreted unchanged in the urine, while the rest is metabolized via the liver. Hematocrit, reticulocyte count, vitamin B12, folate and iron levels should be obtained prior to treatment. Benadryl in the injectable form is effective in adults and pediatric patients, other than premature infants and neonates, for the following conditions when Benadryl in the oral form is impractical. It is important to get each dose of this medication as scheduled. However, vitamin B12 is an essential vitamin and requirements are increased during pregnancy. Available for Android and iOS devices. US residents can call their local poison control center at 1-800-222-1222. The major portion is excreted within the first eight hours. Amounts of vitamin B12 that are recommended by the Food and Nutrition The molecular formula is C17H21NO HCl. A very serious allergic reaction to this drug is rare. Board, National Academy of Science-National Research Council for pregnant women (4 mcg daily) should be consumed during pregnancy. Deficiency has been recognized in infants of vegetarian mothers who were breast fed, even though the mothers had no symptoms of deficiency at the time. There have also been reports of kidney damage, which may require hemodialysis, in people treated with GLP-1 receptor agonists (RA), such as semaglutide. You may report side effects to Health Canada at 1-866-234-2345. bMessage and data rates may apply. Properly discard this product when it is expired or no longer needed. However, ideal storage temperatures range . How long is B12 good for after opened? - Sage-Answers Prompt parenteral administration of vitamin B12 prevents progression of neurologic damage. Cyanocobalamin appears as dark red crystals or as an amorphous or crystalline red powder. If a patient misses a dose, they should administer Ozempicas soon as possible within 5 days after the missed dose. THIS PRODUCT IS FOR INTRAVENOUS OR INTRAMUSCULAR ADMINISTRATION ONLY. Semaglutide should be injected just under the skin into the abdomen, thigh, or upper arm. Discontinue Ozempic. Gastrointestinal absorption of vitamin B 12 depends on the presence of sufficient intrinsic factor and calcium ions. Miscellaneous anxiolytics, sedatives and hypnotics, Benadryl Dosage Charts (Infants & Children). Also, because semaglutide causes a delay in gastric emptying, it may impact the absorption of any medication taken orally. Insulin secretion typically occurs in two phases following a meal, and semaglutide increased both first and second phase insulin secretion. Hematocrit and reticulocyte counts should be repeated daily from the fifth to seventh days of therapy and then frequently until the hematocrit is normal. Parkedale Pharmaceuticals, Inc. Manufactured by: Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which contain aluminum. Intravenous administration results in even more rapid excretion with little opportunity for liver storage. Data sources include IBM Watson Micromedex (updated 1 May 2023), Cerner Multum (updated 17 Apr 2023), ASHP (updated 10 Apr 2023) and others. We comply with the HONcode standard for trustworthy health information. Before using this medication, tell your doctor or pharmacist your medical history, especially of: low potassium blood levels (hypokalemia), gout, kidney disease, a certain blood disorder (polycythemia vera), a certain eye disease (Leber's disease), other vitamin/mineral deficiencies (especially folic acid and iron). Flaxseed oil contains a high concentration of phyto-nutrients that are beneficial to human health, according to the National Center for Complementary and Alternative Medicine. This medication is given by injection into a muscle or under the skin as directed by your doctor. Offer is good for up to 24 months. Do not start, stop, or change the dosage of any medicines without your doctor's approval. May increase the risk of pancreatitis. Do not freeze Ozempicand do not use Ozempicif it has been frozen. If more than five days have passed, skip the missed dose and just administer the next dose on the regularly scheduled day. Pregnancy Category C: Adequate and well-controlled studies have not been done in pregnant women. The chemical name is 5,6-dimethyl-benzimidazolyl cyanocobamide; the molecular formula is C 63H 88CoN 14O 14P. | Taking semaglutide with insulin (as well as other medications such as sulfonylureas that also lower blood sugar levels) increases your risk of hypoglycemia (low blood sugar levels) so monitor yourself for symptoms of low blood sugar which include sweating, shaking, dizziness, a fast heartbeat, and mood changes. If you are prescribed a semaglutide prefilled injection pen, ask your doctor or nurse to show you how to self-administer it before you do it yourself. Such measures remove the need for long-term administration of cyanocobalamin. manufacture(16729-533), analysis(16729-533), Gastrointestinal pathology, dysfunction, or surgery, including gluten enteropathy or sprue, small bowel bacteria overgrowth, total or partial gastrectomy. Ozempicis not indicated for weight loss. Because of the high levels of omega-3, fish oil supplements can reduce cholesterol and possibly reduce inflammation. Doses of folic acid greater than 0.1 mg per day may result in hematologic remission in patients with vitamin B 12 deficiency. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Learn how to store and discard needles and medical supplies safely. In the majority of cases, taking a B vitamin does not cause weight gain. How long is vitamin B12 good for after drawn up? - AnswersAll Antihistamines are also contraindicated in the following conditions: diphenhydramine hydrochloride injection, solution. Keep Neo-B12 Injection in a cool dry place, where the temperature stays below 25C. However, it is generally recommended to store them in a cool, dry place, away from heat, moisture, and light. Supplements in capsules have casings that protect them from oxidation and therefore do not need refrigeration. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Tissue loading may occur at even lower rates of administration. This survey is being conducted by the WebMD marketing sciences department. Cyanocobalamin is quantitatively and rapidly absorbed from intramuscular and subcutaneous sites of injection; the plasma level of the compound reaches its peak within 1 hour after intramuscular injection. Available for Android and iOS devices. For use in parkinsonism, when oral therapy is impossible or contraindicated, as follows: parkinsonism in the elderly who are unable to tolerate more potent agents; mild cases of parkinsonism in other age groups, and in other cases of parkinsonism in combination with centrally acting anticholinergic agents. 1 Sterile Towel Drape Bavla Road, Ta.- Sanand, FAQs | Ozempic (semaglutide) injection 0.5 mg, 1 mg, or 2 mg Accord Healthcare, Inc., This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use. Does methylcobalamin need to be refrigerated? Patients with pernicious anemia have about 3 times the incidence of carcinoma of the stomach as the general population, so appropriate tests for this condition should be carried out when indicated. Available for Android and iOS devices. Will the Ozempic Pen that delivers 0.25 mg and 0.5 mg doses require a new prescription? Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Unless the manufacturer specifies a different (shorter or longer) date for an opened multi-dose that has been opened or accessed (e.g., needle-punctured), the vial should be dated and discarded within 28 days. You can store your vials and ampoules of vitamin B12 cyanocobalamin and B-Complex out of sunlight in a cool room between the stable temperatures 59-86 Fahrenheit or 15-30 Celsius. Folic acid should be administered concomitantly if needed. However, vitamin B 12 is an essential vitamin and requirements are increased during pregnancy. Semaglutide works by mimicking the action of GLP-1, a naturally occurring hormone that helps to regulate blood glucose levels. We comply with the HONcode standard for trustworthy health information. Vitamin B12 helps your body use fat and carbohydrates for energy and make new protein. Do not freeze). Pregnancy Category C. Patients with Normal Intestinal Absorption: We comply with the HONcode standard for trustworthy health information. In people with normal absorption, deficiencies have been reported only in strict vegetarians who consume no products of animal origin (including no milk products or eggs). Vitamin B12 cyanocobalamin vials and ampoules, as well as B-Complex, can be stored out of sunlight in a cool room at 59-86 Fahrenheit (or 15-30 Celsius). Do not share this medication with others. A multi-dose vial is a vial of liquid medication intended for parenteral administration (injection or infusion) that contains more than one dose of medication. The cobalt content is 4.34%. Wipe injection site vigorously and discard. In the young pediatric patient, particularly, they may produce excitation. Glacial acetic acid may has been added during manufacture to adjust the pH (range 4.5-7.0). Will Ozempichelp my patients lose weight? When self-administering an IM injection, the middle third of the thighs vastus lateralis muscle is the easiest location. Intrinsic factor deficiency causes pernicious anemia, which may be associated with subacute combined degeneration of the spinal cord. Fingernails and blue lips chest pain. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch. US22OZM01108January 2023, Learn about the safety profile for Ozempic, A 0.25 mg starting dose and a maintenance dose of 0.5 mg, both available in a red-label pen, A maintenance dose of 1 mg available in a blue-label pen, A maximum maintenance dose of 2 mg available in a yellow-label pen, Contains 2 mg of semaglutide in a 3 mL (0.68 mg/mL) pen, Delivers doses of 0.25 mg or 0.5 mg per injection, Contains 8 mg of semaglutide in a 3 mL (2.68 mg/mL) pen, The most common adverse reactions, reported in 5% of patients treated with Ozempic, There are limited data with semaglutide use in pregnant women to inform a drug-associated risk for adverse developmental outcomes. Rochester, MI 48307. Maximum savings of $150 for a 1-month supply, $300 for a 2-month supply, and $450 for a 3-month supply. Animal studies have reported thyroid C-cell tumors in rats given semaglutide. Follow all instructions closely. The structural formula is as follows: Benadryl in the parenteral form is a sterile, pyrogen-free solution available in a concentration of 50 mg of diphenhydramine hydrochloride per mL. Not considered as first-line therapy for type 2 diabetes. Gamma-Sterilized* Isopropyl Alcohol, 70% by Volume, Nitrile Powder Free Sterile Gloves (Dynarex) - Size 7.5* Cooking doesn't destroy it. Drug classes: Anticholinergic antiemetics, Anticholinergic antiparkinson agents, Antihistamines, Miscellaneous anxiolytics, sedatives and hypnotics. Refrigerate and cover the top after opening a vial. These include liquid vitamins, some essential fatty acids and probiotics. 1 Sterile Adhesive Bandage, DISTRIBUTED BY: High doses of vitamin B-12, such as those used to treat a deficiency, might cause: Headache. Here is what it says: Bragg Liquid Aminos does not need to be refrigerated, either before or after opening/using, as it has a 3 year shelf life. Semaglutide belongs to the class of medicines called GLP-1 receptor agonists. What conditions does Cyanocobalamin (Vit B-12) 1,000 Mcg/Ml Injection Solution treat? Cyanocobalamin Injection, USP is a sterile solution of cyanocobalamin for intramuscular or subcutaneous injection. Fish oils are an essential fatty acid. Do you need to refrigerate Braggs soy sauce? Benadryl Ampoule Do not store in the bathroom. If it can't absorb B-12, it is not used by the body and is lost through stool. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. | Carcinogenesis, Mutagenesis, Impairment of Fertility: Long term studies in animals to evaluate carcinogenic potential have not been done. Antihistamines appear to compete with histamine for cell receptor sites on effector cells. Do not double the dose to catch up. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Information for Patients: Patients with pernicious anemia should be informed that they will require monthly injections of vitamin B12 for the remainder of their lives. What happens to B12 if it isn't refrigerated? Schilling Test: The flushing dose is 1000 mcg. If you use the injected form and administer it to yourself, you will receive vials and syringes (with needles) from the pharmacy. Colchicine para-aminosalicylic acid and heavy alcohol intake for longer than 2 weeks may produce malabsorption of vitamin B 12. The molecular weight is 1355.39. Use of this product intravenously will result in almost all of the vitamin being lost in the urine. cyanocobalamin, injection. It doesn't need to be refrigerated. Vitamin B 12 is not present in foods of plant origin, but is abundant in foods of animal origin. It does not require refrigeration. Vitamin B12 has nine health benefits, all of which are based on scientific evidence. Are there any side effects with B12 injections? It also causes a slowing down in how fast the stomach empties. During the winter, its, Helium Filaments can be extracted from Helium Coils, which appear on the Moon at random in some locations. Vitamin B12 is not present in foods of plant origin, but is abundant in foods of animal origin. Vitamin B12 plays an important role in maintaining the health of your nervous system and red blood cells. Each mL contains 1000 mcg cyanocobalamin. In people with normal absorption, deficiencies have been reported only in strict vegetarians who consume no products of animal origin (including no milk products or eggs). Requirements of vitamin B 12 in excess of normal (due to pregnancy, thyrotoxicosis, hemolytic anemia, hemorrhage, malignancy, hepatic and renal disease) can usually be met with oral supplementation. How has the Ozempic Pen that delivers 0.25 mg and 0.5 mg doses packaging changed? Administer Ozempiconce weekly on the same day each week, at any time of the day, with or without meals. Ozempic(pronounced Oh-ZEM-pick) is a once-weekly injection indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus and to reduce the risk of major adverse cardiovascular (CV) events (CV death, nonfatal myocardial infarction, or nonfatal stroke) in adults with type 2 diabetes mellitus and established CV disease. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Ozempicshould be protected fromexcessive heat and sunlight. Data sources include IBM Watson Micromedex (updated 1 May 2023), Cerner Multum (updated 17 Apr 2023), ASHP (updated 10 Apr 2023) and others. Cyanocobalamin has a long shelf life and is very stable. Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 mcg/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity. If you miss a dose, omit the missed dose and just take the next dose the following day. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. The vitamin B12 coenzymes are very unstable in light. Month is defined as 28 days. See Terms and Conditions of Use at Ozempic.com/terms. Often asked: Why Does Liquid B12 Have To Be Refrigerated? Hematocrit and reticulocyte counts should be repeated daily from the fifth to seventh days of therapy and then frequently until the hematocrit is normal. The upper arms deltoid muscle and the bottoms dorsogluteal site are two other options. The injection is given once a week, on the same day each week (for example, every Monday). However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. Within 48 hours after injection of 100 or 1000 mcg of vitamin B 12, 50 to 98% of the injected dose may appear in the urine. This product contains aluminum that may be toxic. Anaphylaxis and angioedema have also been reported with GLP-1 RAs and the initial administration of semaglutide should preferably be done in a medical facility. B-12 Compliance Injection Description. Cooking doesn't destroy it. It is lost through stool if it cant absorb B-12 because it isnt used by the body. What happens to B12 if not refrigerated? The vitamin B 12 coenzymes are very unstable in light. The vitamin B12 will be absorbed by the surrounding muscle as soon as it is pushed through the needle. Remember that it is best to get your vitamins from healthy foods. Semaglutide lowers blood sugar levels by mimicking the effects of GLP-1, a naturally occurring hormone that stimulates insulin secretion and lowers glucagon secretion from the liver. Consult your pharmacist. Long-term studies in animals to determine mutagenic and carcinogenic potential have not been performed. Selected from data included with permission and copyrighted by First Databank, Inc. 20-25C (68-77 F) [SEE USP CONTROLLED Your body can easily process vitamin B12, which is safe, inexpensive, and easily processed by your body. Can B12 be refrigerated? Dodex Injectable (Cyanocobalamin Injection, USP) is a sterile solution of cyanocobalamin for intramuscular or subcutaneous injection. 4. Manufactured by: If folate levels are low, folic acid should also be administered. In the US - Call your doctor for medical advice about side effects. If any of these effects last or get worse, tell your doctor or pharmacist promptly. Pediatric Use: Intake in children should be in the amount (0.5 to 3 mcg daily) recommended by the Food and Nutrition Board, National Academy of Science-National Research Council. Avoid using the intravenous route. Reproduction studies have been performed in rats and rabbits at doses up to 5 times the human dose and have revealed no evidence of impaired fertility or harm to the fetus due to diphenhydramine hydrochloride. See theA1Candweightresults from a 40-week, randomized, open-label, active-controlled trial in 1201 adult patients with type 2 diabetes comparing Ozempic 0.5mg to Trulicity 0.75mg and Ozempic 1mg to Trulicity 1.5mg.2. Store at controlled room temperature 1530C (5986F). Amounts of vitamin B 12 that are recommended by the Food and Nutrition Board, National Academy of Science-National Research Council for lactating women (4 mcg daily) should be consumed during lactation. Dodex Injection: Package Insert - Drugs.com Canada residents can call a provincial poison control center. Sensitivity to cobalt and/or vitamin B12 is a contraindication. However, some vitamins and supplements require refrigeration to retain their freshness and usefulness.