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The typical IM sites are the deltoid muscle (upper arm) or the gluteal muscle (buttock)
Early trials reported it to be generally well tolerated at low doses, but these studies were small and of short duration
However, it is important to note that neurological symptoms can occur even in the absence of anaemia, particularly in patients taking folic acid supplements, which can mask the blood changes whilst neurological damage progresses
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It is not licensed by the MHRA, is not available on NHS prescription, and has not been appraised by NICE for any indication
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