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Initial treatment for patients with neurological involvement follows British National Formulary (BNF) guidance: Hydroxocobalamin 1 mg intramuscularly on alternate days for approximately 2-3 weeks (or until no further improvement) Maintenance therapy then consists of hydroxocobalamin 1 mg intramuscularly every two months Hydroxocobalamin is preferred over cyanocobalamin in the UK due to superior retention and fewer injections required

Crosby L, Davis B, Joshi S, Jardine M, Paul J, Neola M, et al