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Insert needle, inject air into vial (equalizes pressure) 4

Note: For complete details, please review product monographs at and regularly review current Health Canada advisories, warnings and recalls at: for the most up to date information.) Table 4: Treatment of B 12 deficiency (adapted from Means 2021) 27 Note: Intranasal administration is generally not used

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Injection administration documentation should specify the route (intramuscular), anatomical site, and any immediate patient reactions

L-methymalonyl-CoA mutase converts L-methymalonyl-CoA to succinyl-CoA, which is essential for the metabolism of protein and fat