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This is also where the supply-versus-stability point from the reconstitution section bites: if a reconstituted 10 mg vial holds ~66 doses but the solution is only reliably stable for a few weeks, plan the reconstitution volume so you are not left discarding drug you paid for
For vitamin B12 deficiency caused by autoimmune gastritis, or after a total gastrectomy or complete terminal ileal resection, NICE recommends lifelong intramuscular replacement
It typically presents as macrocytic megaloblastic anemia and neurological impairments, including sensory and motor disfunctions, predominantly in the lower extremities, ataxia, and in more advanced stages cognitive decline progressing to dementia, as well as psychiatric disturbances ( Subclinical B12 deficiency, however, is far more prevalent, affecting up to 26% of the general population
We always offer application a topical cold numbing spray for added comfort
