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Second, when adding liquid to the powder, aim the stream down the side of the vial rather than directly onto the powder

Medications that interfere with B12 absorption (e.g., metformin, proton pump inhibitors)

This is done because the vial is a vacuum, and you need to add an equal amount of air to regulate the pressure, making it easier to draw the medication into the syringe

Neo-B12 Injection contains hydroxocobalamin commonly known as vitamin B12 that is used to treat pernicious anaemia and other forms of macrocytic anaemias caused by a deficiency in vitamin B12