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What the 28-day window requires: The clock starts at first puncture, not at the date printed on the vial
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This means every vial has been compounded under pharmaceutical-grade conditions, tested for sterility and potency, prepared specifically for human administration under a valid prescription, and tracked from source to patient
Passive diffusion accounts for about 1% of total absorption, and this route of absorption is unaffected in patients with pernicious anemia ( There were studies in the 1950s and the1960s that showed that oral vitamin B12 could be absorbed by patients with pernicious anemia and could lead to resolution of the anemia ( The objective of our review is to inform clinicians on the effectiveness of oral vitamin B12 as adequate replacement in patients with pernicious anemia, as well as make recommendations on the dosing and frequency of clinical and laboratory monitoring
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