Anaphylactic reactions to thiamine are exceedingly uncommon (estimated incidence well below 1 %), but they have been documented
The most common adverse events are gastrointestinal: nausea (occurring in 12-33% of subjects depending on dose), diarrhea, constipation, and decreased appetite
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Some people experience slight soreness at the site, which usually fades quickly
Modifier 25: Significant, Separately Identifiable E/M on Same Day as Injection Modifier 25 is appended to the E/M service code, not to CPT code 96372 , when a significant, separately identifiable evaluation and management service is performed on the same day as the injection
Timing: Evening dosing to align with natural sleep onset