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Formulation alternatives may provide relief: Different tablet formulations with alternative inactive ingredients may be better tolerated Liquid preparations can be easier to tolerate and allow flexible dosing Intramuscular injections completely avoid the gastrointestinal tract and are particularly useful for those with absorption issues (such as pernicious anaemia or malabsorption) or persistent oral intolerance Review inactive ingredients: Examine the supplement label for potential irritants or allergens

PMID: 11533304

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When deciding between intramuscular and intravenous, we look at the patients health, how bad their B12 deficiency is, and how they react to treatment

This prevents bacterial growth, making it suitable for multi-dose applications and safe for mixing or diluting injectable medications