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Adequate maternal pyridoxine levels are important for fetal development, and the vitamin is present in prenatal vitamins in amounts roughly equivalent to the Recommended Dietary Allowance (around 1.9 mg per day for pregnant women)

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If neurological symptoms are present, treatment is more intensive: 1 mg on alternate days until no further improvement occurs, then maintenance doses of 1 mg every 2 months

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Allergy risk to cobalt or preservatives (rare) Energy improvement: 24-72 hours Reticulocyte response: 3-5 days Neurological improvement: Weeks to months Hematological normalization: 4-8 weeks Maximum nerve repair: Up to 1 year Injection site reactions (15-20%) Mild diarrhea (initial doses) Itching/eczema (cobalt sensitivity) Transient anxiety (overstimulation) Headache (usually resolves quickly) Serious reactions are extremely rare