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It is made for topical ear use and is intended to deliver vancomycin directly to the affected area

We actually prefer SQ because its painless and has an established track record of effective B12 delivery, whereas IM can be painful and tends to put people off self-injecting

For individuals with fatty liver disease, particularly those with advanced fibrosis or cirrhosis, your specialist may advise complete abstinence

Certain factors may theoretically affect B12 absorption

This is especially important if there is no explanation for the dehydration or it is severe