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After first puncture, refrigerate and use within 28 days

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Calcium appears to decrease levels of dolutegravir through chelation

96 Deficiency of PGK is a rare cause of nonspherocytic hemolytic anemia, often associated with neuromuscular abnormalities

[2] Patients should contact their GP if they experience: Side effects from B12 injections (though these are rare and usually mild) Difficulty attending scheduled injection appointments, as missed doses may lead to symptom recurrence New symptoms developing during treatment Concerns about treatment effectiveness or duration Changes in other medications that might affect B12 absorption Suspected adverse reactions to B12 treatment can be reported through the MHRA Yellow Card scheme (yellowcard.mhra.gov.uk)