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Additionally, vitamin B 12 deficiency can also occur as a result of other malabsorptive conditions (such as inflammatory bowel disease, or pancreatic insufficiency), after certain procedures (such as bariatric surgery, or ileal resection), restricted diets (such as veganism), or the use of certain medications (such as metformin or proton-pump inhibitors)

The tirzepatide autoinjector pen has specific administration steps outlined in the Instructions for Use, including proper placement against the skin and holding the device in place for the full 10 seconds after the second click is heard, ensuring complete medication delivery

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Use in the first trimester has also been associated with increased incidence of gestational diabetes and elevated blood pressure