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[19] [20] More serious but rare risks include pancreatitis (severe abdominal pain radiating to the back), gallbladder disease (right upper quadrant pain, fever, jaundice), and potential thyroid C-cell tumors (based on animal data)

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According to a study published in PubMed Central (National Institutes of Health), intravenous administration of vitamin B12 provides a faster increase in B12 levels compared to oral supplementation, making it a potentially better option for patients with severe deficiency

In addition, patients who concurrently use complementary and alternative medicine (CAM) including herbal supplements, traditional remedies, or over-the-counter botanicalsmay unknowingly alter the pharmacokinetics of oral chemotherapy