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Its used on demand rather than daily, so cumulative exposure is limited compared with maintenance medications

They also suggested that factors that alter the function of the blood-brain barrier (BBB), such as hypoxic or ischemic stroke, inflammation that causes endothelial upregulation of surface adhesion molecules, and disruption of the BBB barrier function by the cancer, may alter the penetration conditions and reduce the permeability of the drug through the BBB [24]

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International journal of molecular sciences, 24(15), 12152

Cyanocobalamin, while not a direct treatment for sexual dysfunction, can be considered as part of a holistic approach to improving a patients overall health, which may in turn support better sexual function

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