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Except under special circumstances, this medication should be not be used when the following medication problem exists: Cyanocobalamin: Leber's disease (optic nerve atrophy has occurred rapidly after administration; Cyanocobalamin concentrations are already elevated).
Risk-benefit should be considered when the following medication problems exist: Thiamine: Sensitivity to Thiamine; Wernicke's encephalopathy (intravenous glucose loading may precipitate or worse this condition in Thiamine-deficient patients; Thiamine should be administered prior to glucose).
Pyridoxine: Sensitivity to Pyridoxine.
Cyanocobalamin: Sensitivity to Cyanocobalamin or Hydroxocobalamin.
