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Indications and Usage for B-12 Compliance Injection Cyanocobalamin is indicated for vitamin B12 deficiencies due to malabsorption which may be associated with the following conditions: Addisonian (pernicious) anemia Gastrointestinal pathology, dysfunction, or surgery, including gluten enteropathy or sprue, small bowel bacteria overgrowth, total or partial gastrectomy Fish tapeworm infestation Malignancy of pancreas or bowel Folic acid deficiency It may be possible to treat the underlying disease by surgical correction of anatomic lesions leading to small bowel bacterial overgrowth, expulsion of fish tapeworm, discontinuation of drugs leading to vitamin malabsorption (see DRUG INTERACTION), use of a gluten-free diet in nontropical sprue, or administration of antibiotics in tropical sprue

Disadvantages: Expensive ($500-$1500 per 4-week course)

However, individuals with more advanced liver disease or those with additional risk factors may require dose reduction or increased caution

State Medicaid programs and manufacturers were requested to submit their intentions to participate by January 8, 2026, and the model is expected to begin in May 2026