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Because a perfectly measured dose of degraded peptide delivers nothing

If you miss a day during the active phase, skip it and continue from where you left off

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Administration happened under supervision with precise measurement

The British National Formulary (BNF) states: For people with neurological involvement Initially administer hydroxocobalamin 1 mg intramuscularly on alternate days until there is no further improvement, then administer hydroxocobalamin 1 mg intramuscularly every 2 months