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Most research involves animal studies, and the Phase 1 human trial completed in 2015 never published results

For patients who are sensitive to the gastric mucosa or require long-term use of Dihexa, capsule formulations can reduce the risk of adverse reactions such as stomach discomfort, nausea, and vomiting caused by the medication

This is a common question

28 However, oral therapy does not improve serum methylmalonic acid levels as well as intramuscular therapy, although the clinical relevance is unclear

As of September 2023 it is on the FDA's Category 2 list of bulk drug substances that may not be compounded due to significant safety risks, and the agency has scheduled a Pharmacy Compounding Advisory Committee (PCAC) review for July 2026 covering proposed uses in opioid withdrawal, chronic insomnia, and narcolepsy

It is the most widely studied of the three, with a large body of preclinical literature on tendons, ligaments, and gut tissue