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Without that, use is off-label and uncoupled from systematic safety monitoring
Pharmacokinetics: Cyanocobalamin is administered intranasally, orally, and parenterally, while hydroxocobalamin is administered only parenterally. Once absorbed, vitamin B12 is highly bound to transcobalamin II, a specific B-globulin carrier protein and is distributed and stored primarily in the liver as coenzyme B12. The bone marrow also stores a significant amount of the absorbed vitamin B12. This vitamin crosses the placenta and is distributed into breast milk. Enterohepatic recirculation conserves systemic stores. The half-life is about 6 days (400 days in the liver). Elimination is primarily through the bile; however, excess cyanocobalamin is excreted unchanged in the urine
consult your provider if persistent
The benzyl alcohol suppresses bacterial growth inside the multi-dose vial after the seal has been punctured
If you are having private injections on top of an NHS schedule, the combined frequency may be higher than either provider realises, which is worth flagging to both
The copper may have dissociated or oxidation occurred
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