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In UK clinical settings, the recognised standard diluent for injectable medicines is Water for Injections BP (single-use, preservative-free), and the choice of diluent must always follow the licensed product's Summary of Product Characteristics (SmPC)

[153] There is evidence that for elderly people, physicians often repeatedly prescribe and administer cyanocobalamin injections inappropriately, evidenced by the majority of subjects in one large study either having had normal serum concentrations or having not been tested before the injections

For most users, cyanocobalamin in compounded tirzepatide provides adequate B12 supplementation

We are licensed and skilled B12 injectors

Exact doses and administration steps are reproduced here only as literature context and must not be adapted for human or veterinary use