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Patients who have experienced allergic reactions to other GLP-1 receptor agonists should be evaluated carefully before initiating treatment with this formulation, as cross-reactivity between different GLP-1 receptor agonists may occur in some individuals

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This means that although most people meet their B12 needs, a significant minority may not have optimal levels, particularly in higher-risk groups

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Note that while elevated homocysteine is associated with an increased risk of Alzheimer's disease, systematic reviews of clinical trials comparing vitamin B12 supplementation to placebo groups have not shown a significant effect in preventing or slowing Alzheimer's disease or cognitive decline