Prescription and administration: Once B12 deficiency is confirmed, GPs prescribe hydroxocobalamin injections according to standardised protocols: Standard loading regimen: 1mg intramuscularly three times weekly for two weeks Neurological involvement: 1mg intramuscularly on alternate days until no further improvement Maintenance therapy: 1mg every three months for life in pernicious anaemia or malabsorption conditions (or every two months if there was neurological involvement) Injections are typically administered by practice nurses at GP surgeries
The BBB prevents almost 98% of small molecule drugs and nearly all large-molecule therapeutics such as recombinant peptides, proteins, anti-sense agents, and genetic vectors, from reaching the brain [1]
I., Sakai, K., Kaida, Y., Yokoro, M., Ueda, S.,
It is common among the aging population and significantly associated with colon cancer, hepatic encephalopathy, and stroke (2)