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The methylcobalamin cofactor plays a role in the two- step synthesis of methionine by transferring the methyl radical from 5- methyltetrahydrofolate to the two- electron reduced cobalamin and then from the one- electron reduced methylcobalamin to homocysteine

FDA , and Lilly says as much in its complaint

The convenience of oral tablets may matter to patients who sometimes avoid injectables out of aversion to needles

Clin Nutr Open Sci

[15] that included patients with intracranial hypertension and a self-reported sulfa allergy found that 37% of patients on acetazolamide and/or furosemide had no cross-reactivity, 56% had predictable adverse reactions specific for the medication, and 7% of the cases had urticaria

Its use is supported by extensive clinical research and guidelines