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Gastrointestinal issues: If youve been diagnosed with gastrointestinal disorders such as celiac disease or Crohns disease, or youve undergone gastrointestinal surgery, you may require B12 injections

After that, many patients shift to monthly doses for maintenance

Contraindications and Precautions Some people should be careful or not get vitamin B12 injections at all

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The oral-contraceptive interaction is a separate study (GPGR), reported in the FDA Mounjaro NDA 215866 summary review: a single 5 mg tirzepatide dose with a combination oral contraceptive (0.035 mg ethinyl estradiol / 0.25 mg norgestimate) reduced the Cmax of norelgestromin and ethinyl estradiol by 55% to 59% a range spanning both analytes, not a separate figure for each with AUC lowered 28.8% (norelgestromin) and 27% (ethinyl estradiol), and tmax delayed 2.5 to 4.5 hours