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Anyone who is pregnant or planning to get pregnant should also make sure they are getting enough folic acid

1 Mecobalamin 50 mg or placebo was administered intramuscularly twice weekly for 16 weeks to 130 ALS patients who had suffered from ALS for less than one year, were classified as definite, probable, or probable-laboratory supported according to the Updated Awaji Criteria, had an ALS severity rating of grade 1 or 2, had a decrease of 1 or 2 points in the total score on the Revised ALS Functional Rating Scale-Revised (ALSFRS-R) 12 weeks prior to administration, and had a forced vital capacity (%FVC) of more than 60%

including IL-6, IL-10, IL-12, IL-17, IL-21, IL-23 [184,185,186]), tumor necrosis factor-alpha, and B-lymphocyte activating factor