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Since B12 is a water-soluble vitamin, excess amounts are typically eliminated through urine

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Side effects and adverse reactions Common and expected events (often due to opioid withdrawal): Nausea, vomiting Agitation, irritability Sweating Tremor Tachycardia, hypertension Body aches, myalgias Serious but less common: Pulmonary edema Cardiac arrhythmias and myocardial ischemia (rare) Seizures Severe acute opioid withdrawal with associated complications Recurrent respiratory depression after initial reversal (due to longer‑acting opioids) Warnings Emergency treatment only: naloxone is an immediate, temporary antagonist and not a substitute for comprehensive emergency care, airway management, and observation