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It must only be given under medical supervision

In cyanocobalamin, the cobalamin molecule is attached to a cyanide molecule, which the body must detoxify and excrete

Yes....there are a whole host of drugs that impede the absorption of vitamin B12...and folate...and many others vitamins and minerals too (PPI's, H2 antagonists, and prednisilone is another prime example)

A Certificate of Analysis (COA) is published on the product page and independently verifiable at verify.janoshik.com using the batch reference number

That is far weaker than a Phase 1 human trial

These patches contain a formula of B vitamins, along with biotin, folic acid, niacinamide and choline