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After that, take a 4-week break before starting again

Intramuscular (IM) route of vitamin B12 administration: The sublingual (SL) route of vitamin B12 administration has been evaluated as an alternative route to oral and IM routes, especially in the case of vitamin B12 malabsorption

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Maintain aseptic technique during all handling and reconstitution steps

Metformin (for diabetes), proton pump inhibitors (such as omeprazole or esomeprazole), and H2 blockers (such as famotidine) can all reduce B12 absorption over time

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