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Injectable B12 has few direct drug interactions, but certain medications can interfere with B12 absorption or measurement: Chloramphenicol: This antibiotic may antagonise the haematological response to B12 in some patients, potentially preventing the expected rise in red blood cell count

The peptide normalized enzyme markers of muscle damage including creatine kinase, lactate dehydrogenase, aspartate aminotransferase, and alanine aminotransferase, indicating restoration of muscle cell membrane integrity and metabolic function

National Library of Medicine (US), MedlinePlus

Cyanocobalamin is also contraindicated in patients with cobalt hypersensitivity because cyanocobalamin contains cobalt