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Storage method: In a cool dry place at a temperature not exceeding 25 degrees
Patients with vitamin B12 deficiency and concurrent renal or hepatic disease may require increased doses or more frequent administration of methylcobalamin
It is simply an honest assessment of the clinical evidence
A reasonable titration schedule might look like this: Week 1: 200mcg once daily Week 2: 300mcg once daily Week 3 onward: 300-500mcg based on response and tolerance Optimizing injection technique Poor injection technique contributes to injection site reactions and potentially to other effects like nausea from anxiety around the process
On the other hand, secondary loss of response may be mediated by either pharmacodynamic (mechanistic) or pharmacokinetic (immune or non-immune) factors
Not for the reason most people assume
