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Advantages of oral form over IM injection: Less nursing time on injections Less complexity of care Less discomfort/pain Less bleeding in patients who take anticoagulants Less costly according to some analyses Disadvantages of oral form over IM injection:: Greater risk of non-compliance In 1991, a survey done on Minneapolis internists led one commentary to conclude that oral vitamin B 12 replacement for pernicious anemia was one of medicines best kept secret. 18 In 1996, when the survey was repeated again in the same area, awareness and use of oral vitamin B 12 for pernicious anemia had increased substantially (019%), but the majority of doctors still remain unaware of this treatment option (61%)

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Healthcare providers will determine when it is safe to have another dose

However, the further clinical development of pramlintide/metreleptin combination therapy has been discontinued by the manufacturing companies because of safety concerns [249](Table 3 )