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Specific clinical scenarios where injections are the standard of care include pernicious anemia, severe malabsorption syndromes, post-bariatric surgery when oral supplementation has failed, and critically low serum B12 levels accompanied by neurological deterioration

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Patients should be educated about signs and symptoms of potential serious adverse effects, including pancreatitis, gallbladder disease, and severe hypoglycemia if receiving concurrent antidiabetic therapy