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Although epidemiologic studies have shown an association between vascular disease and hyperhomocysteinemia, large randomized controlled trials have shown that lowering homocysteine levels in these patients does not reduce the number of myocardial infarctions or strokes, or improve mortality rates

CPT 62323 is interlaminar (needle placed between the laminae in the midline or paramedian position)

Its strong copper coordination is thought to improve its pharmacokinetic profile by allowing slow, localized action rather than broad systemic exposure

Real-life reviews show a mix of experiences

The usual dose is 1000 mcg (1 mL)