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Crosses the blood-brain barrier

In clinical practice, this form becomes part of the patients permanent medical record

Aminoglycosides, tetracyclines, and certain other antibiotics may alter gut microbiota composition, potentially affecting the small amount of vitamin B12 that is produced by colonic bacteria, though this is generally not clinically significant for patients receiving injectable B12 supplementation

Work Cited: Bahardoust, M., Aghakhani, Z., Mousavi, S., Donyadideh, G., Ziafati, H., Alipour, H., Haghmoradi, M., Olamaeian, F., Tayebi, A., & Tizmaghz, A

Safety Profile Summary A formal preclinical safety evaluation published in 2020 by Xu et al