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The pain is usually sudden, sharp, and intense

However, the cyanocobalamin form of B12 does not occur in nature normally, but is a byproduct of the fact that other forms of B12 are avid binders of cyanide (-CN) which they pick up in the process of activated charcoal purification of the vitamin after it is made by bacteria in the commercial process

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If you want modest regenerative support as part of a broader health optimization protocol, the lower effective dose from oral administration might provide sufficient benefit

Altman, Doxorubicin pathways: pharmacodynamics and adverse effects

The combined effects could produce excessive sedation or respiratory depression