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Shaking can shear delicate peptide chains and introduce foam
Over four draws from a 10mg vial, this can mean losing 0.04 to 0.2ml of solution, enough to reduce your final dose by 5 to 10%
Peptides are short chains of amino acids (the building blocks of proteins) that can have a range of effects on the body
The skin may be stretched or pinched to facilitate easier insertion, depending on the site and muscle mass
One example is the Jarisch-Herxheimer reaction, which may occur in those treated for syphilis or Lyme disease
If the patient is suspected to be sensitive to cobalt or other components of cobalamin, an intradermal test dose is recommended (10, 13)
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