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Advantages of oral form over IM injection: Less nursing time on injections Less complexity of care Less discomfort/pain Less bleeding in patients who take anticoagulants Less costly according to some analyses Disadvantages of oral form over IM injection:: Greater risk of non-compliance In 1991, a survey done on Minneapolis internists led one commentary to conclude that oral vitamin B 12 replacement for pernicious anemia was one of medicines best kept secret. 18 In 1996, when the survey was repeated again in the same area, awareness and use of oral vitamin B 12 for pernicious anemia had increased substantially (019%), but the majority of doctors still remain unaware of this treatment option (61%)

PLoS ONE 8 , e77986 (2013)

Cyanocobalamin is more common and has a shorter body retention

Payers audit whether the documented service actually constitutes plan development work not general therapy or unrelated administrative tasks

Proper technique and site selection can help minimize discomfort