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Optic Nerve Atrophy: Administering cyanocobalamin to patients with Leber's disease or hereditary optic nerve atrophy should be done cautiously, as it may worsen the condition

However, this increase remained within the safe range, and there were no significant differences in the amount of 3%NaCl, NSS, or 5%DW administered between the two groups within 48 h

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These instances are relatively rare and usually depend on the individuals skin type, hormonal balance, and overall health

Titrate: Increase to 500 mcg once daily from week 3 if the lower dose is well tolerated