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However, it is important to note that hydroxocobalamin is not effective in treating pernicious anemia, which is caused by an autoimmune disorder

This is another reason why higher concentrations (10-20mg/mL) are preferred for higher doses, and why the reconstitution charts emphasize these concentrations for the escalation and maintenance phases

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We received one comment indicating that adopting a range would be more burdensome than encoding the exact amount and are thus finalizing that hospitals must encode the count of allowed amounts

High dose oral cobalamin would be a reasonable alternative as maintenance in patients unable to tolerate intramuscular injections provided there is good compliance with treatment