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Pre-Use Checklist Before using any B12 nasal spray: Talk to your healthcare provider if you have: Lebers hereditary optic neuropathy A known allergy to cobalt or B12 (cyanocobalamin or methylcobalamin) History of severe megaloblastic anemia, polycythemia vera, or bone marrow disorders Low iron or folate, significant kidney issues, or are on chemotherapy agents Persistent nasal congestion, chronic sinus issues, or recurrent upper respiratory infections Review your medications and supplements , especially: Chloramphenicol Omeprazole and other PPIs Aminosalicylic acid Colchicine Bone marrowsuppressing drugs Step-By-Step Administration For best results with a methyl b12 nasal spray such as Synchronicity Healths formula: Avoid hot food and drinks Do not eat or drink hot liquids for at least 1 hour before and 1 hour after using the spray