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Topical and Nasal AOD-9604 Topical and nasal forms appear in marketing, but the FDA review found no published human exposure data for transdermal or intranasal AOD-9604

Higher plants do not concentrate methylcobalamin from the soil, making them a poor source of the substance as compared with animal tissues

the clinical relevance of this finding in humans is unknown, and in UK and EU prescribing information this is noted as a precaution rather than a formal contraindication but individuals with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2 (MEN2) should discuss this with their doctor