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Serious reactions are uncommon when administered under clinical supervision, but any unusual or concerning symptoms should be discussed with a licensed healthcare provider right away
Mechanisms of Action Hydroxocobalamin is a precursor of the active coenzyme forms of vitamin B (methylcobalamin and adenosylcobalamin)
Section 5 says
About 10% of tirzepatide participants had a heart-rate increase above 20 bpm during escalation, compared with 3% on placebo. A lean Japanese cohort reached +10 to +13 bpm, and 23% of Japanese participants at 15 mg crossed the abnormal-pulse threshold versus 7% of other participants, despite only 17% higher exposure. Lean and East Asian bodies showed greater cardiovascular sensitivity than exposure alone predicted
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