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Since B12 is processed in the liver, excessive amounts could potentially lead to complications in severe liver conditions

10.1371/journal.pone.0161208 45 RebiereH.GuinotP.ChauveyD.BrenierCh

Patients should avoid ingesting large amounts of vitamin C within 1 hour of oral vitamin B12 administration Extended release potassium products Antibiotics such as gentamicin, neomycin, tobramycin Anti-seizure medications such as phenobarbital, phenytoin, primidone Medicines used to treat heartburn like H2 blockers such as cimetidine and proton pump inhibitors such as omeprazole Antacids such as ranitidine, cimetidine Vitamin B12 Injection Storage and Safety Information Vitamin B12 tablets should be in a cool and dry place

Safety Profile Toxicology studies using doses far exceeding human therapeutic ranges have not identified significant adverse effects