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The study was modified after randomization and treatment of 117 patients to require that all patients receive folic acid 350 mcg to 1000 mcg daily beginning 1 to 3 weeks prior to the first dose of pemetrexed and continuing until 1 to 3 weeks after the last dose, vitamin B12 1000 mcg intramuscularly 1 to 3 weeks prior to first dose of pemetrexed and every 9 weeks thereafter, and dexamethasone 4 mg orally, twice daily, for 3 days starting the day prior to each pemetrexed dose

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But can B12 make you nauseous when you take it

That means considering hormone balance, gut health, micronutrient status, and lifestyle factors alongside any advanced therapy

Post-Surgical Patients Patients who have undergone certain types of surgeries, particularly those involving the gastrointestinal tract, may experience difficulties with B12 absorption