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According to NICE Clinical Knowledge Summaries and the British National Formulary (BNF), the recommended treatment regimens are: For patients without neurological involvement : Initial treatment: hydroxocobalamin 1 mg intramuscularly three times a week for 2 weeks Maintenance: hydroxocobalamin 1 mg intramuscularly every 3 months for life For patients with neurological involvement : Initial treatment: hydroxocobalamin 1 mg intramuscularly on alternate days until no further improvement Maintenance: hydroxocobalamin 1 mg intramuscularly every 2 months for life If neurological symptoms are present, treatment should be started urgently to prevent irreversible damage

Compounded prescription: Prepared by a licensed 503A compounding pharmacy pursuant to a valid prescription from a licensed prescriber

High Standards: Manufactured in a GMP-compliant facility

If they do, the next step would be a proposed rule published in the Federal Register , opening a public comment period that typically lasts 60 to 90 days

What dose should be given