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Warnings: Patients with early Leber's disease (hereditary optic nerve atrophy) may experience severe and rapid optic atrophy when treated with vitamin B12. Additionally, treating severe megaloblastic anemia with vitamin B12 can lead to fatal hypokalemia due to increased erythrocyte potassium requirements

The risks are substantial and multi-layered

A commonly extrapolated human-equivalent dose is roughly 2 to 10 micrograms per kilogram, though no human dose-ranging trial has been completed or published

Lidocaine and verapamil are both used to treat cardiac arrhythmias and have bioavailability less than 40%, but lidocaine is never given orally because its metabolites are believed to contribute to central nervous system toxicity