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As the However, while risks of severe toxicity are low, some side effects are still possible, such as: temporary symptoms, such as itching, swelling, or diarrhea allergic reaction damage from the injection hypokalemia, or low potassium levels infection negative interactions with certain medications, such as: metformin (Fortamet, Glucophage, Riomet) medications to reduce gastric acid, such as proton pump inhibitors or H2 receptor antagonists Always talk with a doctor before using vitamin B12 supplements