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Its fatty acid modification (the C20 diacid) adds some bulk and hydrophobic character that can promote aggregation at elevated temperatures, but the overall stability profile is manageable with basic refrigeration practices

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Nascobal Nasal Spray is indicated for the maintenance of normal hematologic status in pernicious anemia patients who are in remission following intramuscular vitamin B12 therapy and who have no nervous system involvement

According to the Vitamin B12 is present in a range of foods, including: eggs poultry fish meat milk and other dairy products beef liver clams some fortified breakfast cereals and nutritional yeasts Dietary supplements are also available for those who do not consume enough vitamin B12 as part of their diet

For example, if you have a deficiency and need regular B12 injections, hydroxocobalamin can be given once every 3 months, whereas cyanocobalamin would need to be given every month