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Footnotes Contributors: TAS, IK, MH and RKC conceived the study, and contributed to study design, sample size calculations and analytical plans
Dosing typically begins at a lower dose, suggested initiation of 4 units (0.04 mL) weekly for the first 4 weeks, then escalates according to a titration schedule: Weeks 1-4: Inject 4 units (0.04 mL) one time per week Weeks 5-8: Inject 8 units (0.08 mL) one time per week Weeks 9-12: Inject 18 units (0.18 mL) one time per week Weeks 13-16: Inject 30 units (0.3 mL) one time per week Week 16+: Inject 44 units (0.44 mL) one time per week Dosing may deviate from this pattern to accommodate patient-specific needs
Examples include: Antimetabolites: Drugs like methotrexate, which block DNA synthesis, can be lessened by high B12 levels
Research on patient preferences consistently shows overwhelming preference for nasal formulations, with feedback describing them as fastest and simplest. The elimination of needle-related anxiety, pain, and the need for sterile technique significantly reduces barriers to consistent therapy adherence
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