Esocard 100mg Injection belongs to a group of medicines called beta-blockers. It is used to treat emergency high blood pressure (hypertension), angina (heart-related chest pain), irregular heart rhythms (arrhythmia). Esocard 100mg Injection is administered under the supervision of a doctor or nurse. You should not self-administer this medicine at home. The dose and frequency depend on what you are taking it for and the severity of your condition. It is generally given along with continuous monitoring of blood pressure and heart rate. The main side effects of this medicine are fatigue, headache, slow heart rate, feeling dizzy, and nausea. These are usually mild and short-lived. It may also cause shortness of breath or low blood pressure in some people. To reduce the risk of side effects your doctor will probably start the medicine at a low dose and gradually increase it. Consult your doctor if the side effects bother you or do not go away.

Dobier S 50mg Injection Salt: Dobutamine (50mg) INTRODUCTION ABOUT DOBIER S 50MG INJECTION DOBIER S 50MG INJECTION contains Dobutamine which belongs to the group of medicines called Cardiac Stimulants. It is used to improve heart functions. It restores heartbeat and blood pressure to normal levels among patients undergoing open heart surgery and in patients having heart failure or any other severe heart conditions that reduces heart rate (such as shock or cardiomyopathies (enlargement of heart muscles)). It can also be used as an alternative to exercise during stress testing (a procedure used to detect heart problems). DOBIER S 50MG INJECTION is suitable for use both in adults and in children (including infants). Before receiving DOBIER S 50MG INJECTION inform your doctor if you have asthma or any other respiratory disorders. You must also inform your doctor if you have any allergic conditions or low blood volume as a precaution. DOBIER S 50MG INJECTION is not suitable for stress testing in patients having any heart or blood vessels disorders that hinder blood flow. It is also not recommended for use in pregnant and in breastfeeding women unless considered necessary by the physician. The most common side effects of receiving DOBIER S 50MG INJECTION are fast heartbeat, headache, high or low blood pressure, shortness of breath, inflammation at the injection site, nausea and urge to pass urine. Consult your doctor if any of these side effects worsens. USES OF DOBIER S 50MG INJECTION Improves heart functions by restoring normal heartbeat and blood pressure Manage heart failure Manage shock (cardiogenic or septic shock) Manage any heart conditions that may result in poor circulation around the body (such as cardiomyopathies, open heart surgery) Used as an alternative to exercise during stress testing HOW DOBIER S 50MG INJECTION WORKS DOBIER S 50MG INJECTION is a cardiac stimulant. It stimulates the heart and improves heart functions. It helps your heart to work more effectively by strengthening the pumping action of the heart. It also improves blood circulation around the body by expanding the blood vessels present all over the body. DIRECTIONS FOR USE DOBIER S 50MG INJECTION will be given only by a doctor or by a trained healthcare professional into the vein (intravenously). Your doctor will decide the correct dose, duration of therapy and site of administration for you depending upon your age, body weight and health condition. SIDE EFFECTS OF DOBIER S 50MG INJECTION COMMON increased heart rate chest pain abnormal heartbeat, palpitations high or low blood pressure narrowing of the blood vessels headache wheezing, shortness of breath increase in WBC count in blood increased bleeding tendency urge to pass urine nausea skin rash fever inflammation at the injection site HOW TO MANAGE SIDE EFFECTS Headache: Try to take rest. Apply a pain-relieving balm on your forehead. If the symptom does not improve, consult with your doctor. Nausea: Stick to simple meals. Avoid eating oil rich or spicy foods. Consult your doctor if your symptom worsens. Skin rash: Avoid hot showers because hot water can irritate your skin further. Do not scratch the affected area. Use protective clothing when going outdoors. Regularly moisturize your skin. Consult your doctor if your skin rash worsens. Inflammation at the site of injection: Place an ice pack on the injected site. Do not move the affected area frequently. If the symptom worsens, consult your doctor. WARNING & PRECAUTIONS PREGNANCY DOBIER S 50MG INJECTION is not recommended for use in pregnant women unless considered necessary by the physician. Therefore, inform your doctor before receiving this medicine if you are pregnant or think you may be pregnant or planning to have a baby. BREASTFEEDING DOBIER S 50MG INJECTION is not recommended for use in breastfeeding women. Therefore, inform your doctor before receiving this medicine if you are breastfeeding. DRIVING AND USING MACHINES Do not drive or operate any machines if your ability is affected by DOBIER S 50MG INJECTION. ALLERGY Do not receive DOBIER S 50MG INJECTION if you are allergic to Dobutamine. LUNGS DOBIER S 50MG INJECTION should be used with caution in patients with asthma or any allergic or respiratory conditions. Therefore, consult your doctor before receiving it. HEART DISEASE DOBIER S 50MG INJECTION is not recommended for use in patients who have narrowing of blood vessels supplying the heart (coronary artery stenosis) or other heart disorders. It should be used with caution in patients with other heart problems (such as coronary artery disease, or acute heart failure). Therefore, consult your doctor before receiving it. OTHERS DOBIER S 50MG INJECTION is not recommended for use if you: have low blood volume (hypovolaemia) have any disorders in the blood vessels that hinders blood flow Before receiving DOBIER S 50MG INJECTION, inform your physician if you:

INTRODUCTION ABOUT VALCYTE 450MG TABLET VALCYTE 450MG TABLET contains Valganciclovir which belongs to the group of medicines called Antiviral agents. It is used in adults (with acquired immunodeficiency syndrome) to manage cytomegalovirus (CMV) infection of the retina of the eye which generally cause vision problems and blindness. VALCYTE 450MG TABLET is also used in adults and children to manage cytomegalovirus (CMV) infection who are not infected with CMV or who had received an organ transplant from someone who earlier had CMV infection. VALCYTE 450MG TABLET is not recommended for use in patients allergic (hypersensitive) to Valganciclovir, and/or Ganciclovir. Before taking VALCYTE 450MG TABLET, inform your doctor if are undergoing radiotherapy/hemodialysis, and/or suffer from low red blood cell, white blood cell or platelets, kidney/liver problems. VALCYTE 450MG TABLET is not recommended for use in pregnant women unless it is clearly necessary since it may cause harm to the unborn baby. It is also not recommended for use in breastfeeding women. VALCYTE 450MG TABLET should be used with caution in children and adolescents (aged below 18 years) and is advised to be used with caution in elderly patients (aged 65 years and above) after consulting the doctor. The most common side effects of taking VALCYTE 450MG TABLET are oral thrush (fungal infection), headache, shortness of breath, abdominal pain, loss of appetite, nausea, vomiting, and/or diarrhea. Consult your doctor if any of these symptoms worsens. USES OF VALCYTE 450MG TABLET Manage cytomegalovirus (CMV) infection of the retina of the eye in adult patients with acquired immunodeficiency syndrome (AIDS). Prevents cytomegalovirus (CMV) infection who are not infected with CMV or in patients who had received an organ transplant from someone who earlier had CMV infection HOW VALCYTE 450MG TABLET WORKS VALCYTE 450MG TABLET works by managing the multiplication of virus in human cells by decreasing its growth which results in inhibition of production of new virus thus managing and managing the spread of infection to other parts of the body in affected individuals. DIRECTIONS FOR USE Take VALCYTE 450MG TABLET as advised by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition. SIDE EFFECTS OF VALCYTE 450MG TABLET COMMON thrush & oral thrush (fungal infection) upper respiratory tract infection such as sinusitis, tonsillitis headache cough, shortness of breath abdominal pain, loss of appetite, nausea/vomiting, diarrhea, weight loss eczema (skin inflammation) tiredness, fever influenza signs of urine infection such as fever, passing urine more often, and/or pain (while passing urine) skin infection signs of mild allergic reaction such as red, itchy skin feeling depressed, anxious or confused trouble sleeping feeling numb/weak in hands/feet changes in sense of touch, tingling/tickling/pricking/burning sensation altered taste, chills eye inflammation/pain or sight problems ear pain signs of low blood pressure such as feeling dizzy/faint difficulty while swallowing constipation, wind, indigestion, stomach pain, swelling of abdomen mouth ulcers night sweats itching, rash hair loss back pain, muscle/joint pain, muscle spasms feeling dizzy, weak/generally unwell UNCOMMON feeling agitated tremor/shaking deafness irregular heartbeat red itchy welt, dry skin blood in urine chest pain RARE Stop taking VALCYTE 450MG TABLET and contact your doctor if you experience any of the following side effects: signs of allergic reaction (anaphylactic shock) such as raised, itchy skin rash, sudden swelling of throat, face, lips/mouth resulting in difficulty while swallowing/breathing, and/or sudden swelling of the hands, feet/ankles. signs of infection (due to low white blood cell count) such as sore throat, mouth ulcer, and/or fever signs of low red blood cell count such as shortness of breath, tiredness, palpitation, and/or pale skin signs of blood infection (sepsis) such as fever, chills, palpitation, confusion, and/or slurred speech signs of low platelet count such as bleeding/bruising, blood in urine/stools, and/or bleeding from gums severely low blood cell count pancreatitis (inflammation of pancreas) associated with severe stomach pain fits hallucinations abnormal thoughts/feelings, losing contact with reality failure of kidney function HOW TO MANAGE SIDE EFFECTS Constipation Try to eat high-fiber foods such as vegetables, cereals, fresh fruit, and drink plenty of water. Involve in regular exercise (such as going for a daily walk or run) and if this does not help, consult and inform your doctor for receiving alternate managements for constipation.

INTRODUCTION ABOUT TAXONAB 100MG INJECTION TAXONAB 100MG INJECTION contains Paclitaxel which belongs to a group of anti-cancer medicines called Taxanes. TAXONAB 100MG INJECTION is used to manage ovarian and breast cancer as a first line of therapy and as a second line of management when platinum containing medicines (such as cisplatin) or anthracyclines are insufficient to manage the disease in affected individuals. TAXONAB 100MG INJECTION is also used to manage advanced NSCLC (non-small cell lung cancer) when surgery/radiation therapy is not suitable. The medicine is also indicated for use to manage AIDS-related Kaposi’s sarcoma when other managements (such as anthracyclines) are insufficient to manage the disease in affected individuals. TAXONAB 100MG INJECTION is not recommended for use in patients allergic to paclitaxel and polyoxyethylated castor oil. It is also not recommended for use in patients with few white blood cells count and serious & uncontrolled infection. The medicine is also not used in patients suffering from severe liver disease. Before receiving TAXONAB 100MG INJECTION, inform your doctor if you had previously received radiation to your chest and/or suffering from thrombocytopenia (low platelet count)/acute infections (such as herpes zoster, chickenpox, herpes), kidney problems (such as chronic kidney disease), liver problems (such as mild/moderate hepatic impairment) and/or heart problems (such as severe coronary artery disease, myocardial infarction and arrhythmias). TAXONAB 100MG INJECTION is not recommended for use during pregnancy. Women of child-bearing potential should use effective contraception method while receiving TAXONAB 100MG INJECTION which should be continued for next-6 months after completing the management. The medicine is also not recommended for use in breastfeeding women. TAXONAB 100MG INJECTION is also not recommended for use in children and adolescents (aged below 18 years). The medicine can be used with caution in elderly patients (aged above 65 years) after consulting the doctor. The most common side effects of receiving TAXONAB 100MG INJECTION are minor allergic reactions (such as flushing, rash, itching), shortness of breath, sore throat/mouth ulcers, diarrhea, nausea, vomiting and/or loss of hair. Consult your doctor if any of these symptoms worsen. USES OF TAXONAB 100MG INJECTION Manage ovarian and breast cancer. Manage advanced NSCLC (non-small cell lung cancer) Manage AIDS-related Kaposi’s sarcoma in affected individuals. HOW TAXONAB 100MG INJECTION WORKS TAXONAB 100MG INJECTION works by interfering with the microtubule structures in the cell (substance which aids cancer cells to divide and multiply) thus inhibiting the growth of cancer cells and managing its spread in affected individuals. DIRECTIONS FOR USE TAXONAB 100MG INJECTION will be given to you only by a doctor or a nurse into a vein as an intravenous infusion. Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition. SIDE EFFECTS OF TAXONAB 100MG INJECTION COMMON minor allergic reactions such as flushing, rash and/or itching infections such as upper respiratory infection, urinary tract infection shortness of breath sore throat/mouth ulcers, sore and red mouth diarrhea, nausea, vomiting loss of hair pain in the muscles, cramps, joints fever, severe chills, headache, dizziness, tiredness, looking pale bleeding, bruising more easily than normal signs of peripheral neuropathy such as numbness, tingling/weakness in arms and legs temporary mild nail change and skin changes reactions at injection sites such as localized swelling, pain and/or redness of the skin. UNCOMMON septic shock (severe drop in blood pressure) due to infections racing heartbeat, rapid beating of the heart, respiratory distress, heart attack, heart block fatigue, sweating, fainting, significant allergic reactions, phlebitis (inflammation of a vein), swelling of the face, lips, mouth, tongue and/or throat back pain, chest pain, pain around hands and feet, chills, abdominal pain. RARE febrile neutropenia (type of fever) due to low white blood cell count associated with fever and increased risk of infection motor neuropathy (disease that affects your body’s motor nerves) pulmonary embolism (blockade of lung artery), lung fibrosis (damaged/scarred lung tissue), interstitial pneumonia (scarring of lung tissue), pleural effusion (build of fluid between lungs and chest) bowel obstruction, bowel perforation, inflammation of colon, inflammation of the pancreas (pancreatitis) skin redness peritonitis (inflammation of abdominal layer) fever, dehydration, weakness anaphylactic reactions (life threatening allergic reaction). HOW TO MANAGE SIDE EFFECTS Diarrhea: Drink plenty of water and stay hydrated. Try to avoid taking any medicine on your own to manage diarrhea. Consult your doctor and inform them if the symptom gets worse.

INTRODUCTION ABOUT I DOX 20MG INJECTION I DOX 20MG INJECTION contains Doxorubicin which belongs to the group of medicines called Anti-cancer agents. It is used to manage certain types of cancers. It is used either alone or along with other anti-cancer medicines. Cancer is a disease in which some of the cells of the body grow uncontrollably and spread to other parts of the body. Before receiving I DOX 20MG INJECTION, inform your doctor if you have or ever had heart disease, either before or during radiotherapy, had or having live or live-attenuated vaccinations, are currently taking or have recently taken Trastuzumab (used in the management of certain cancers). There are no adequate and well-controlled studies in pregnant women. Consult your doctor during breast-feeding before starting management with this medicine as it may pass through the breast milk and possibly harm your child. Consult your doctor for advice before receiving the medicine. The most common side effects of I DOX 20MG INJECTION are infection, lack of appetite, inflammation in the mouth, diarrhea, nausea, vomiting, reddening, swelling, pain, numbness and tingling in the palms and feet may also occur whilst being managed with this medicine. Hair loss is very common and may be quite severe, beard growth may stop in men, fever, feeling weak, chills, abnormal ECG (electrical trace of the heart) results, raised levels of liver enzymes (as detected by a blood test) can determine if the medicine is having an abnormal effect on your liver, weight increased in patients with early breast cancer. USES OF I DOX 20MG INJECTION Used to manage certain types of cancer HOW I DOX 20MG INJECTION WORKS I DOX 20MG INJECTION works by suppressing the activity of an enzyme (topoisomerase II) involved in the DNA multiplication of the cancer cells. On the other hand, this also forms harmful chemicals (free radicals) which cause damage to the DNA. This slowdown the growth of cancer cells and eventually works against them. DIRECTIONS FOR USE I DOX 20MG INJECTION will be administered intravenously (IV) into the vein by your doctor or nurse. Your doctor will administer the correct dose and duration for you depending upon your age, body weight and disease condition. SIDE EFFECTS OF I DOX 20MG INJECTION COMMON infection lack of appetite inflammation in the mouth diarrhea nausea, vomiting hair loss beard growth may stop (in men) redness, swelling and blistering on the palms of the hands and soles of the feet (palmar-plantar erythrodysesthesia syndrome) chills weakness abnormal ECG raised levels of liver enzymes weight increased in patients with early breast cancer blood poisoning heart problems conjunctivitis (red watery eyes) lacrimation, excess tear production shortness of breath and swelling of the ankles increased heart rate inflammation of the throat and gullet stomach pain skin rashes, redness, hives nails and skin may appear darker than usual injection site reactions such as redness and swelling neutropenia thrombocytopenia malaise/asthenia infertility (in women) absence or decrease in sperm count (in men) UNCOMMON embolism (blockage in the bloodstream) RARE Stop receiving I DOX 20MG INJECTION and contact your doctor immediately if you experience any of the following side effects: dizzy, feverish, short of breath with a tight chest or throat or having an itchy rash anemia (low red blood cell count) decrease in white blood cell counts which in turn causes an increase in infections and a raised temperature (fever) platelets can be affected which could make a bruise or bleed more easily decreased activity in bone marrow reddening of urine dehydration inflammation of veins irritation or bleeding in the intestines inflammation of the lining of the stomach heartburn soreness or ulcers in the mouth

Dopacan Injection is a brand of Dopamine Hydrochloride, a potent vasopressor and inotropic agent used in critical care settings to manage various cardiovascular conditions. It is administered intravenously under medical supervision. ________________________________________ 🩺 Medical Uses Dopacan Injection is indicated for: • Shock Management: Including septic shock, cardiogenic shock, and hypovolemic shock. • Acute Heart Failure: To improve cardiac output and perfusion. • Severe Hypotension: Especially in patients unresponsive to volume resuscitation. • Renal Protection: To enhance renal blood flow and urine output in certain critically ill patients. Dopamine works by stimulating dopaminergic and beta-adrenergic receptors, leading to increased heart rate, contractility, and renal perfusion. At higher doses, it also stimulates alpha-adrenergic receptors, causing vasoconstriction and increased blood pressure. ________________________________________ ⚙️ Dosage and Administration Dopacan Injection is administered intravenously, with the dosage tailored to the patient's condition and response: • Low Dose (1–5 mcg/kg/min): Primarily stimulates dopaminergic receptors, increasing renal blood flow and urine output. • Medium Dose (5–15 mcg/kg/min): Stimulates beta-1 adrenergic receptors, enhancing heart rate and contractility. • High Dose (15–50 mcg/kg/min): Stimulates alpha-1 adrenergic receptors, leading to vasoconstriction and increased blood pressure. Continuous monitoring of blood pressure, heart rate, and urine output is essential during administration. ________________________________________ ⚠️ Precautions and Contraindications Before using Dopacan Injection, inform your healthcare provider if you have: • Allergies to dopamine or other components of the injection. • A history of heart rhythm disorders or coronary artery disease. • Pheochromocytoma (a rare tumor of the adrenal glands). • Diabetes, asthma, or sulfite allergies. • Circulatory disorders such as Raynaud's disease or Buerger's disease. • Recent use of monoamine oxidase inhibitors (MAOIs). This medication is typically administered by healthcare professionals in a clinical setting and is not intended for self-administration. ________________________________________ 💊 Side Effects Common side effects may include: • Palpitations or increased heart rate. • Nausea and vomiting. • Headache. • Difficulty breathing. • Gangrene (in rare cases, due to excessive vasoconstriction). Serious side effects are rare but can occur. Seek immediate medical attention if you experience symptoms like chest pain, shortness of breath, or signs of gastrointestinal bleeding.

Dobutacan 12 Injection is a brand of Dobutamine Hydrochloride 12.5 mg/mL, a synthetic catecholamine used in critical care settings to support heart function. It is administered intravenously under medical supervision. ________________________________________ 🩺 Medical Uses Dobutacan 12 Injection is indicated for: • Cardiac Decompensation: Acute heart failure due to conditions like myocardial infarction, cardiomyopathies, or post-cardiac surgery. • Cardiogenic Shock: A state of low cardiac output leading to inadequate tissue perfusion. • Septic Shock: A severe infection causing low blood pressure and organ dysfunction. • Stress Echocardiography: As a pharmacological agent to assess coronary artery disease when exercise is not feasible. It works by stimulating beta-1 adrenergic receptors, increasing heart contractility and stroke volume, thereby improving cardiac output. ________________________________________ ⚙️ Dosage and Administration Dobutacan 12 Injection is administered intravenously in a hospital setting. The typical dosage ranges from 2.5 to 10 mcg/kg/min, adjusted based on the patient's response. In some cases, doses up to 20 mcg/kg/min may be required. ________________________________________ ⚠️ Precautions and Contraindications Before using Dobutacan 12 Injection, inform your healthcare provider if you have: • Allergies to dobutamine or other components of the injection. • A history of arrhythmias or heart disease. • Kidney or liver problems. • A history of stroke or blood clots. This medication is typically administered by healthcare professionals in a clinical setting and is not intended for self-administration. It is usually given as an intramuscular (IM) or intravenous (IV) injection. ________________________________________ 💊 Side Effects Common side effects may include: • Headache • Nausea or vomiting • Dizziness or lightheadedness • Injection site reactions (pain, redness, or swelling) Serious side effects are rare but can occur. Seek immediate medical attention if you experience symptoms like chest pain, shortness of breath, or signs of gastrointestinal bleeding.

Diclocan AQ Injection is a brand of Diclofenac Sodium 75 mg/ml, a nonsteroidal anti-inflammatory drug (NSAID) used to manage acute pain and inflammation. It is commonly prescribed in clinical settings for conditions where rapid pain relief is necessary. ________________________________________ 🩺 Medical Uses Diclocan AQ Injection is utilized for: • Acute Inflammatory Conditions: Such as rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. • Musculoskeletal Injuries: Including sprains, strains, and fractures. • Postoperative Pain: For pain management following surgical procedures. • Acute Gout Attacks: To alleviate pain and inflammation associated with gout. • Renal and Biliary Colic: For pain relief due to kidney stones or gallstones. The injection works by inhibiting the synthesis of prostaglandins, chemicals in the body responsible for inflammation and pain . ________________________________________ ⚠️ Precautions and Contraindications Before administering Diclocan AQ Injection, inform your healthcare provider if you have: • Allergies to diclofenac or other NSAIDs. • A history of gastrointestinal issues, such as ulcers or bleeding. • Heart, liver, or kidney problems. • High blood pressure or a history of stroke. • Pregnancy, especially in the third trimester, or breastfeeding. This medication is typically administered by a healthcare professional in a clinical setting and is not intended for self-administration. It is usually given as an intramuscular (IM) or intravenous (IV) injection. ________________________________________ 💊 Side Effects Common side effects may include: • Injection site reactions (pain, redness, or swelling). • Nausea or vomiting. • Dizziness or headache. • Gastrointestinal discomfort. Serious side effects are rare but can occur. Seek immediate medical attention if you experience symptoms like chest pain, shortness of breath, or signs of gastrointestinal bleeding. ________________________________________

Cynocan 12 Injection is a brand of Cyanocobalamin (Vitamin B₁₂) used to treat and prevent vitamin B₁₂ deficiency. Cyanocobalamin is a synthetic form of vitamin B₁₂, which is essential for nerve function, red blood cell formation, and DNA synthesis. ________________________________________ 🩺 Medical Uses Cynocan 12 Injection is prescribed for: • Pernicious Anemia: A condition where the body cannot absorb vitamin B₁₂ due to a lack of intrinsic factor. • Vitamin B₁₂ Deficiency: Caused by dietary insufficiency, malabsorption, or certain medical conditions. • Neurological Symptoms: Such as numbness, tingling, or weakness in the limbs. • Fatigue and Weakness: Associated with low vitamin B₁₂ levels. • Megaloblastic Anemia: A blood disorder characterized by the presence of abnormally large red blood cells. ________________________________________ ⚙️ Mechanism of Action Cyanocobalamin is converted in the body to its active forms, methylcobalamin and adenosylcobalamin, which are involved in: • DNA Synthesis: Essential for proper cell division. • Red Blood Cell Formation: Prevents anemia. • Nerve Function: Maintains the health of nerve cells. ________________________________________ 💉 Administration and Dosage Cynocan 12 Injection is administered by a healthcare professional: • Intramuscular (IM) or Subcutaneous (SC) Injection: Typically given in a clinical setting. • Dosage: Varies based on the individual's condition and response to treatment. For specific dosing instructions, consult your healthcare provider. ________________________________________ ⚠️ Side Effects Common side effects may include: • Injection site reactions (pain, redness, swelling) • Headache • Nausea or vomiting • Dizziness • Fatigue Serious side effects are rare but can occur. Seek immediate medical attention if you experience symptoms like chest pain, shortness of breath, or swelling in the legs. ________________________________________ ⚠️ Precautions Before using Cynocan 12 Injection, inform your healthcare provider if you have: • Allergies to cyanocobalamin or any other components of the injection. • Leber's disease (a hereditary optic nerve disorder). • Kidney or liver disease. • A history of blood clots or stroke. Cyanocobalamin may interact with certain medications. Inform your doctor about all the medicines you are taking, including over-the-counter drugs and supplements.