Is AHK-Cu safe for long-term use
Use oral therapy when clinically appropriate
Cherry-red skin is a clinical feature described in cyanide poisoning although infrequently observed thought to be due to high venous blood oxyhaemoglobin concentration, but there will not be a change in the colour of the urine
However, vegans might need to rely on supplements to ensure adequate intake
Summary: Adults with B12 deficiency and nerve pain typically require 1 mg hydroxocobalamin injections intramuscularly on alternate days until symptoms improve, followed by maintenance injections every two months
Intramuscular (IM) B12 injections using hydroxocobalamin, the preferred licensed form in the UK are recommended when: Oral supplementation has failed to correct a documented deficiency The patient has difficulty adhering to daily oral regimens Serum B12 levels remain persistently low despite adequate oral dosing There is clinical evidence of neurological or haematological complications In line with BNF guidance, the standard IM regimen for confirmed deficiency without neurological involvement is a loading course of 1 mg hydroxocobalamin on alternate days for two weeks , followed by maintenance of 1 mg every three months