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While you dont need to have a large meal before your appointment, having a light snack or meal a few hours beforehand is beneficial, especially if you tend to feel lightheaded or have low blood sugar

Certain drugs, such as the diabetes drug metformin may have an impact on B12 absorption, which may require supplementation

[14] Application to open wounds, mucous membranes, or periorbital skin is discouraged, and patients with a history of contact dermatitis to dicarboxylic acids or vitamin B3 analogs should undergo a supervised patch test

Additionally, menaquinone can induce both apoptotic and non-apoptotic cell death in cancer cells in solid tumors (104106)