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Injection Technique General subcutaneous guidance from clinical best-practice resources [8] [12]

It has been reported that an average of 630% of patients could show vitamin B12 deficiency due to metformin use.[] As per UK MHRA, decreased vitamin B12 levels, or vitamin B12 deficiency, are now considered to be a common side effect in patients on metformin treatment, especially in those receiving a higher dose or longer treatment duration and in those with existing risk factors

It is distributed rapidly to tissues with high metabolic activity like the liver, kidneys, and muscles

Once reconstituted keep this medicine in a refrigerator between 36F to 46F (2C to 8C)

NICE and British National Formulary (BNF) guidance recommend 1 mg hydroxocobalamin on alternate days until no further improvement in symptoms is observed