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Common side effects include, but may not be limited to: pain or redness at the injection site mild diarrhea pruritus (itching) increased swelling joint pain dizziness headache nervousness or anxiety Serious side effects may include: allergic reactions peripheral vascular thrombosis hypokalemia (low potassium levels) pulmonary edema (fluid build-up around or in the lungs) thrombocytosis congestive heart failure There have been reports of anaphylactic shock and death after the parenteral administration of vitamin B12

Chronic injuries especially may require 8 to 12 weeks before significant improvement becomes apparent

Generally, you will start to see improvements within two weeks, usually in terms of vomiting and/or diarrhea frequency

It usually produces less weight loss than tirzepatide, but it has the longest outcomes record in the class: fewer cardiovascular events, slower kidney decline, and years of diabetes-trial safety data