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If pepsin formation is compromised, the ability of protein bound vitamin B12 to be freed for additional preparations for absorption will be compromised.2-7 In addition, the increase gastric pH also contributes to a greater degree of bacterial colonization and replication within the gastrointestinal tract, thus potentially leading to bacterial overgrowth.2 If bacterial overgrowth also occurs then additional vitamin B12 that was originally ingested for absorption will be utilized by the enteric bacteria thereby reducing the final amount of vitamin B12 available for absorption in the terminal ileum of the small intestine

Contraindication: Do not use in animals with known hypersensitivity to components of the product

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Patients should be offered this alternative after an informed discussion on the advantages and disadvantages of both treatment options. oral vitamin B12 is an effective alternative to vitamin B12 IM injections Cochrane Review