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Cyanocobalamin Injection, USP is a sterile solution of cyanocobalamin for intramuscular or subcutaneous injection. Each mL contains 1000 mcg cyanocobalamin. Each vial also contains Sodium Chloride, 0.9%. Benzyl Alcohol, 1.5%, is present as a preservative and Water for Injection q.s. Hydrochloric acid and/or sodium hydroxidemay have been added during manufacture to adjust the pH (range 4.5-7.0)

The interaction very rarely results in a pernicious anemia that appears reversible with discontinuation of metformin or with Methylcobalamin, vitamin B12 supplementation

Practical Interpretation The mechanistic plausibility (NNMT NAD SIRT1/PGC-1 BMR & fat oxidation) is strong and consistent across preclinical models