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The FDA designated it as a bulk drug substance that cannot be used in compounding under 503A or 503B pharmacies as of recent guidance updates

People who eat less meat or dairy might not get enough from their food

These include: Meat Fish Poultry Milk Eggs Fortified breakfast cereals Fortified breads Fortified nutritional yeasts Fortified plant milks If you follow a vegan diet (meaning you don't eat any animal products, including meat, milk, cheese, and eggs) or you're a vegetarian who doesn't eat enough eggs or dairy products, you could be lacking in vitamin B12

Leaving reconstituted vial at room temperature accelerates degradation 5

Medications like omeprazole, cimetidine, lansoprazole, and folate can interfere with B12 absorption