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In a study of 10 healthy male volunteers, omeprazole, in doses of 20 mg40 mg per day, caused a significant decrease in the oral absorption of methylcobalamin, vitamin B12

ALS is characterized by aberrant buildup of mutant superoxide dismutase (SOD) 1 protein complexes (Quatorze et al.)

[3] The doses used in these tendon studies typically ranged from 10 to 200 micrograms per kilogram of body weight, administered once daily, which when extrapolated to a 75-kilogram human would suggest a working range of approximately 200 to 500 micrograms per day

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But oral forms retain value for specific applications, particularly gastrointestinal protection where local effects complement systemic absorption