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Romani L, et al

Several groups have demonstrated that HMCDs alone have some cytotoxic activities at higher supra-micromolar concentrations

10.1042/BST20180136 191 TahergorabiZ.KhazaeiM
Moreover, hypoxia-induced signaling pathways facilitate adaptive modifications in erythrocyte metabolism, encompassing changes in glycolytic flux and levels of 2,3-bisphosphoglycerate (2,3-BPG), which influence oxygen delivery efficacy
When administered, it directly binds to toxic cyanide ions, forming harmless cyanocobalamin, which is then safely excreted in the urine