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The interaction very rarely results in a pernicious anemia that appears reversible with discontinuation of metformin or with Methylcobalamin, vitamin B12 supplementation

Post-injection soreness (described as muscle ache similar to post-vaccine soreness) occurs in 41% of patients and lasts 24-36 hours

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Some medicines and hydroxocobalamin may interfere with each other

The potential relationship between GLP-1 receptor agonists like semaglutide and thyroid C-cell tumors has been observed in rodent studies, where dose-dependent and duration-dependent increases in thyroid C-cell tumors were noted