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It contains a cyano (cyanide) group in its structure, which makes it more stable than other forms of vitamin B12 as the cyanide stabilizes the molecule from deterioration

10.1016/s0140-6736(21)01640-8 49 SinghG.KrauthamerM.Bjalme-EvansM

The emergence of pancreatitis in this population raises questions about whether the drugs risk-benefit profile was appropriately communicated and whether additional warnings should have been implemented as prescribing patterns shifted

Lpez-Soldado I, Fuentes-Romero R, Duran J, Guinovart JJ

doi: 10.1530/JOE-15-0467 23 PetersonHRRothschildMWeinbergCRFellRDMcLeishKRPfeiferMA