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This mechanism becomes clinically important when using high-dose oral supplements (typically 1000 micrograms or more), as it can provide adequate absorption even when the intrinsic factor pathway is impaired

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Mistake 7: reusing needles Each needle insertion through the rubber stopper dulls the tip and risks introducing contaminants

doi:10.1186/s40662-016-0063-5

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When hydroxocobalamin is given in high doses (such as during cyanide poisoning treatment), unique effects can be observed: patients often experience a transient reddening of the skin or mucous membranes and a reddish discoloration of the urine due to drug excretion