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[9] Visual disturbances have been reported in patients with Leber hereditary optic neuropathy, and rapid B12 administration may precipitate optic nerve atrophy in this genetically predisposed population, mandating extreme caution or alternative therapy
Most people begin to feel improvements in energy and mental clarity within a few days, though mood, nerve, and red blood cell benefits continue to build over several weeks
Dosing information Usual Adult Dose for Pernicious Anemia: Initial dose: 100 mcg intramuscularly or deep subcutaneous once a day for 6 to 7 days If clinical improvement and reticulocyte response is seen from the above dosing: 100 mcg every other day for 7 doses, then: 100 mcg every 3 to 4 days for 2 to 3 weeks, then: Maintenance dose: 100 to 1000 mcg monthly Duration of therapy: Life Comments: Administer concomitant folic acid if needed
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