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Once a vial is opened, refrigeration (28 C) is recommended per typical laboratory SOPs to extend usable life within the 28-day post-puncture window

Patients with pernicious anaemia, malabsorption disorders (such as Crohn's disease or coeliac disease), or following gastric surgery require regular B12 supplementation to prevent serious complications including megaloblastic anaemia and neurological damage

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Discuss any active prescription with a qualified clinician before considering use

Mecobalamin improved pernicious anemia in an elderly individual with Hashimotos disease and diabetes mellitus Of course, were not suggesting you treat PA with oral tablets