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Preclinical cell and animal studies have examined its interaction with the VEGFR2 (vascular endothelial growth factor receptor 2) signaling pathway, with one study reporting activation and upregulation of VEGFR2 in endothelial cell culture models (Hsieh et al., Journal of Molecular Medicine , 2017)

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After a single hydroxocobalamin injection, therapeutic levels can be maintained for approximately 8 to 12 weeks in most patients, which aligns with the standard maintenance schedule of injections every 2-3 months recommended in the British National Formulary (BNF)