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[20] Treatment of megaloblastic anemia with concurrent vitamin B 12 deficiency using B 12 vitamers (including cyanocobalamin), creates the possibility of hypokalemia due to increased erythropoiesis (red blood cell production) and consequent cellular uptake of potassium upon anemia resolution

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Many adults remain stable on 1,000 mcg once monthly, though dose intervals can be adjusted according to serum markers

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[11] It is less preferred than hydroxocobalamin for treating vitamin B 12 deficiency because it has a slightly lower bioavailability

Tissue loading may occur at even lower rates of administration