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The ability of hydroxocobalamin to rapidly scavenge and detoxify cyanide by chelation has resulted in several acute animal and human studies using systemic hydroxocobalamin doses at suprapharmacological doses as high as 140 mg/kg to support its use as an intravenous (IV) treatment for cyanide exposure

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Many patients choose the compounded route specifically because the predictable cash price is lower than the branded copay over a year of treatment

Brief exposure during normal handling (removing the vial cap, drawing a dose) is acceptable as long as the overall environment stays below 86 degrees

304,305 The procoagulatory state induced by sleep apnea may be a contributing factor in its association with an increased risk of heart attack and stroke