The TB-500 recommendation does not change the status of TB-4 because the two are different molecules. KPV On July 23, 2026, PCAC voted to recommend adding KPV to the 503A Bulk Drug Substances List
doi: 10.1136/annrheumdis-2014-205809 307 CribbsAPTerlecki-ZaniewiczSPhilpottMBaardmanJAhernDLindowMet al
Summary: Vitamin B12 toxicity from supplementation is extremely rare, but persistently elevated serum levels may indicate underlying liver disease, kidney dysfunction, or haematological disorders requiring medical investigation
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