Patient/caregiver was educated on precautions to be exercised while taking Cyanocobalamin as follows:

  1. Fluid loss, secondary to the diarrhea the supplement might induce, can contribute to the low blood pressure numbers, and can lead to episodes of confusion and dizziness. The diarrhea and episodes of confusion and dizziness can be self-limiting and resolve over time. Observing compliance with proper rehydration and fluid resuscitation measures recommended, can help prevent episodes of hypotension and thereby contain accompanying confusion and dizziness. Sudden change of position can make the confusion and dizzy episodes even worse and precipitate accidents and falls. Observing compliance with DME prescribed, if any, and avoiding sudden changes in position, during intake of Cyanocobalamin, can help prevent falls and accidents. Stay away from activities, such as, driving and operating heavy machinery, until you are used to the side effects caused by Cyanocobalamin intake. Report any episodes of unresolved dizziness and confusion, while taking Cyanocobalamin. Discuss with your physician and other health care personnel regarding all your medications and their risk of causing confusion and dizziness.
  2. Periodical labs could be drawn for blood cell counts, to evaluate improvement with cell count and anemia. Labs could also be drawn for therapeutic blood levels of Cyanocobalamin. Observe compliance with any lab draws ordered.