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In the UK, standard maintenance therapy for pernicious anaemia is typically hydroxocobalamin 1mg by intramuscular injection every three months (or every two months if neurological symptoms are present), as per BNF and NICE guidance

Even though it is inexpensive, we do not recommend cyano B12 to anyone because the body must use a methylation reaction to cleave its cyanide molecule, which is a demanding process

For road trips, use an insulated bag with ice packs, and avoid leaving your medication in the car for long periodsespecially in hot weather or direct sunlight