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The sterile solution water for injection plus 0.9% benzyl alcohol inhibits bacterial growth without sterilizing the solution outright, which is exactly the property you want when a single vial may be drawn from multiple times over days or weeks
However, evidence of elevated-B12-induced harm is steadily increasing
Other side effects reported ranged from lipohypertrophy at injection site, papilloedema (related to cranial hypertension), and facial nerve paralysis [276, 285], however symptoms did not prevail after treatment pause and restarting with lower doses [268]
The difference between 0.9% and 0.4% is the difference between 28-day preservation and 7-day preservation, and only the assay number tells the story
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