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The standard treatment for vitamin B12 deficiency involves administering cobalamin (either hydroxo- or cyanocobalamin) via intramuscular injection

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The overall risk appears low in clinical trials, but vigilance is advised

In a pre- and post-natal study in rats administered subcutaneous doses of 0.02, 0.10, or 0.25 mg/kg tirzepatide twice weekly from implantation through lactation, F1 pups from F0 maternal rats given 0.25 mg/kg tirzepatide had statistically significant lower mean body weight when compared to controls from post-natal day 7 through post-natal day 126 for males and post-natal day 56 for females