The patient should simply get the next injection at the earliest convenient time
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While B12 supplements benefit those with deficiencies, most people without a deficiency wont see additional benefits from taking extra oral vitamins or injections
However, the gastrointestinal side effects associated with tirzepatideparticularly nausea and diarrhea during dose escalationcan theoretically impact oral pill absorption if they occur within a critical absorption window
The reasonable reading is not these are known to be dangerous that would overstate the evidence in the other direction but rather that safety is genuinely uncharacterized for combined, injected, long-term use, and that product-quality risk sits on top of that biological uncertainty