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Cyanocobalamin injections should be used cautiously in those patients with benzyl alcohol hypersensitivity

Patients usually do not need to use a disinfectant on the skin, but if they do, they should allow it to dry completely before injecting

Clean the skin using isopropyl alcohol on a cotton ball or an isopropyl alcohol wipe

Pharmacokinetics: Cyanocobalamin is administered intranasally, orally, and parenterally, while hydroxocobalamin is administered only parenterally. Once absorbed, vitamin B12 is highly bound to transcobalamin II, a specific B-globulin carrier protein and is distributed and stored primarily in the liver as coenzyme B12. The bone marrow also stores a significant amount of the absorbed vitamin B12. This vitamin crosses the placenta and is distributed into breast milk. Enterohepatic recirculation conserves systemic stores. The half-life is about 6 days (400 days in the liver). Elimination is primarily through the bile; however, excess cyanocobalamin is excreted unchanged in the urine