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Application protocol: Product: Hydrocortisone 1% cream (available at any pharmacy without prescription) Timing: Apply after noticing the reaction, not before injection Amount: Thin layer covering the entire affected area plus a 1-centimeter margin Frequency: Twice daily (morning and evening) until the reaction resolves Duration: Typically 2 to 5 days, do not use for more than 7 consecutive days without medical guidance Important: Do NOT apply hydrocortisone before injection, as it can interfere with medication absorption For reactions that do not respond to 1% hydrocortisone, a healthcare provider can prescribe stronger topical corticosteroids (triamcinolone 0.1% or betamethasone 0.05%)

Key points: Formulation: Most commonly, cyanocobalamin or hydroxocobalamin in aqueous solution is used

[9] High-dose niacin (used to treat cholesterol) lacks human safety data in pregnancy and could theoretically affect the fetus (for example, by causing hypotension or altering lipid metabolism)

Folate levels should be checked before or alongside B12 treatment