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It contains a small percentage of benzyl alcohol (typically 0.9%) which acts as a preservative, preventing bacterial growth in the multi-dose vial once it is mixed
A larger phase 2b trial by Metabolic Pharmaceuticals (the original sponsor) in 2007 with 534 obese patients failed to show statistical superiority over placebo at 24 weeks
[1] Particular concerns with multi-dose vials include dosing errors (confusion between mg, mL, or units) and contamination from repeated access
However, if your B12 levels are healthy, a shot is unlikely to be the answer to your exhaustion, as fatigue has many other potential origins
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