Maintenance and preventive vitamin B₁₂ supplementation in adults

For maintenance therapy following initial supplementation for severe anaemia or neurological symptoms, use:

hydroxocobalamin 1000 micrograms intramuscularly, every 2 to 3 months. hydroxocobalamin hydroxocobalamin hydroxocobalamin

For maintenance therapy following initial supplementation in all other patients, or for prevention in patients at risk of vitamin B₁₂ deficiency, use:

1cyanocobalamin spray 500 to 1000 micrograms sublingually, daily cyanocobalamin cyanocobalamin cyanocobalamin

OR

1hydroxocobalamin 1000 micrograms intramuscularly, every 2 to 3 months hydroxocobalamin hydroxocobalamin hydroxocobalamin

OR

1mecobalamin 1000 micrograms sublingually, daily mecobalamin mecobalamin mecobalamin

OR (if gastrointestinal absorption is not impaired)

1cyanocobalamin 50 to 200 micrograms orally, daily. cyanocobalamin cyanocobalamin cyanocobalamin