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Comment: A few commenters noted that for small, rural hospitals, delays in the ability to transfer patients are frequently out of their control

The duration of B12 injection effectiveness can vary based on the type of injection administered (hydroxocobalamin, cyanocobalamin, methylcobalamin) and individual metabolism

This documentation prevents confusion when you return to the vial for subsequent doses and helps track any inconsistencies in response that might indicate degradation or error

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If exposed, therapy with varicella zoster immune globulin (VZIG) or pooled intravenous immunoglobulin (IVIG), as appropriate, may be indicated

Anecdotally, benzyl alcohol also has a mild local anesthetic effect