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It is important to note that Hydroxocobalamin 20 mg/ml Injection Solution should not be used in patients with known hypersensitivity to hydroxocobalamin or any of the other ingredients in the solution

Substances in Category 2 (deemed to have safety risks) and Category 3 (deemed to have insufficient evidence for FDA evaluation) may not be compounded

Curr Neuropharmacol 2016;14(8):857-865

Exposure to toxins, whether that is environmental toxins from gasoline or plastic or, you know, whatever industrial activity, or it is exposure to ethanol from all the drinks you are having or it is exposure to cigarette smoke from what you are smoking or what someone else is smoking in the enclosed room with you