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Storage conditions that shorten unopened shelf life: heat (extended exposure above 25C), freezing and re-thawing (can crack the stopper seal), direct sunlight (degrades benzyl alcohol), and humid environments (can degrade label readability and obscure exp date)
Safety: What Are the Risks
The clinical consequence ranges from local inflammation through to systemic hypersensitivity and antibody formation
[13] Chloramphenicol has been shown to blunt reticulocyte response to cyanocobalamin, while ethanol, colchicine, and nitrous oxide interfere with cobalamin metabolism or utilization, each warranting clinician awareness when evaluating suboptimal treatment outcomes
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