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However, dedicated cardiovascular outcome trials have not been conducted with pramlintide, and the cardiovascular implications remain secondary to its established glycemic and weight management benefits

Taylor Clark, PharmD, clinical assistant professor of pharmacy practice at Binghamton University, State University of New York Compounding and the FDA: Questions and Answers

Although generally safe, injections should be used with caution in people with a history of allergic reactions to cobalamin or in people with Leber's disease (hereditary optic neuropathy), as B12 may worsen the condition

However, 6 of the 12 admitted patients were exposed to supratherapeutic doses, while 4 patients reportedly injected therapeutic doses