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Options include: Changing from one oral tablet formulation to another with different excipients Discussing sublingual preparations as an alternative (though evidence doesn't suggest superior absorption to oral tablets) For those on injections, checking the specific product's SmPC for excipient information In the UK, hydroxocobalamin injection is the licensed first-line treatment for B12 deficiency requiring parenteral therapy

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View Abstract [13] Vogel JU, Cinatl J, Dauletbaev N, Buxbaum S, Treusch G, Cinatl J Jr, Gerein V, Doerr HW