Store B12 injections in a cool, dry place, typically below 77F (25C) and avoid leaving them in hot environments, such as inside a car, near a stove, or in direct sunlight for extended periods
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In Canada, advice from the British Columbia Medical Association outlines that 1 mg daily oral CN-Cbl should be used for pernicious anemia or food-bound cobalamin malabsorption (FBCM) whereas in most other cases, a daily dose of 250 g may be used ( In Netherlands, controversy arose when the Dutch Organization of General Practitioners published a 2014 viewpoint that 1 mg daily oral OH-Cbl can be utilised as treatment in cases with a cobalamin count below 148 pmol/L and clinical symptoms, with the Dutch B12 Society disputing the efficacy of this and insisting that the advice from the Dutch Healthcare Institute Pharmacotherapeutic Compass should be followed instead (IM/SC starting dose of 10 injections of 1 mg OH-Cbl at intervals of at least 3 days
Pull the plunger back to draw the prescribed dose of B12 into the syringe
But it could be helpful to screen people for B12 deficiency in advance and give them B12 supplements to delay or prevent the onset of depression