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Nascobal (Cyanocobalamin, USP) Nasal Spray 500 mcg/spray 0.125 mL [Label]

Pattern across both trials Nausea, vomiting, and diarrhea peaked during dose escalation and tapered during maintenance

In general, monoclonal antibodies (mAbs) are the most widely used class of biologics ( Monoclonal antibodies account for a growing number of blockbuster drugs with their US sales reaching over $24 billion ( To date, over 73 mAbs have been approved by the United States Food and Drug Administration (FDA) and the European Medicines Agency (EMA)

But these were cardiovascular trials, primarily designed to satisfy the FDA guidance on proving cardiovascular safety, which serendipitously revealed not just safety, but reduced cardiovascular and kidney outcomes with these drugs