Hydroxocobalamin Availability Over the Counter
Hydroxocobalamin is NOT available over the counter—it requires a prescription and is administered as an intramuscular injection by healthcare professionals. 1, 2
Prescription-Only Status
Hydroxocobalamin is a prescription medication that must be administered intramuscularly, typically in a clinical setting by trained medical personnel 2, 3
The standard therapeutic formulation is 1 mg (1000 mcg) hydroxocobalamin given via intramuscular injection, which cannot be self-administered in most jurisdictions and requires medical supervision 1, 4
In the UK and many other countries, hydroxocobalamin injections are the standard treatment for vitamin B12 deficiency and are administered by healthcare providers, not available for over-the-counter purchase 3, 4
Over-the-Counter Alternatives
Oral cyanocobalamin (a different form of vitamin B12) IS available over the counter in doses ranging from 500-2000 mcg daily 1
Oral vitamin B12 supplements can be purchased without prescription and are effective for dietary deficiency or mild malabsorption when taken at high doses (1000-2000 mcg daily) 1, 3
However, oral formulations are generally insufficient for patients with significant malabsorption issues (pernicious anemia, ileal resection, post-bariatric surgery), who require prescription intramuscular hydroxocobalamin 4
Clinical Context
The distinction matters because hydroxocobalamin injections are specifically indicated for patients with malabsorption who cannot adequately absorb oral B12, requiring the injectable prescription form 2, 4
For simple dietary deficiency (vegans, vegetarians, elderly with poor intake), over-the-counter oral cyanocobalamin supplements are typically sufficient and do not require prescription hydroxocobalamin 2