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Due to their high efficacy, many ototoxins are still used despite the risk of hearing loss

The parenteral administration also halts the progression of neurological damage associated with B12 deficiency, but the complete improvement of the condition may depend on the severity and extent of the deficiency.[12][13] Contraindications & Precautions Cyanocobalamin is contraindicated in those with hypersensitivity to cobalt moiety or cobalamin molecule due to the risk of anaphylaxis.[21] Warnings: The use of cyanocobalamin is warned in patients with early Lebers disease as there have been reports of severe and swift optic atrophy with its administration

Symptoms of Vitamin B12 deficiency may include fatigue, weakness, pale skin, shortness of breath, tingling or numbness in hands and feet, and difficulty maintaining balance

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