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Inadequate secretion of intrinsic factor, resulting from lesions that destroy the gastric mucosa (which can be caused by ingestion of corrosives, extensive tumors, and conditions associated with gastric atrophy, such as multiple sclerosis, certain endocrine disorders, iron deficiency, and subtotal gastrectomy) Structural lesions leading to vitamin B 12 deficiency, including regional ileitis, ileal reactions, and malignancies Competition for vitamin B 12 by intestinal parasites or bacteria

However, its potential direct toxicity on the heart remains controversial and needs further investigation

Source: Medscape Drug Interaction Checker Why Is Latuda So Expensive

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The single most common error is misreading the vial: confusing mg with mcg, or assuming the vial amount is per mL rather than total