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24 25 Some patients may experience recurrence or worsening of symptoms when the interval between injections is extended or extended too quickly, and report that continuation of frequent intramuscular hydroxocobalamin injections, varying between twice weekly and once every three to four weeks, 65 is needed to remain asymptomatic

You won't experience any major side effects from this medication

Adding too much water dilutes the solution, potentially requiring larger injection volumes that increase discomfort

Older people usually produce less stomach acid and therefore less intrinsic factor, increasing their risk for deficiency

PMID 16249424