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Parenteral administration bypasses intrinsic-factor–dependent absorption, providing delivery that is unaffected by malabsorption or impaired gastric function.4 After entering circulation, MeCbl binds transcobalamin II (TCII) to form holotranscobalamin (holoTC), enabling cellular uptake through CD320 receptor–mediated endocytosis, followed by lysosomal processing and intracellular trafficking to B12-dependent enzymes.1 Vitamin B12 is widely distributed in tissues and stored predominantly in the liver, contributing to its slow turnover and long biological retention time.4 05 Dosage and Administration Labeled Administration The methylcobalamin injection product discussed in this review is labeled for intramuscular (IM) administration

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Walnuts, grapefruit juice, and dietary fiber can also affect the absorption of Synthroid