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There is ongoing debate on the more effective method, with some preferring local injections for direct injury treatment, although systemic administration is also believed to be effective 3 4

Roseff SJ

Conversely, if a patient presents with pernicious anemia or severe neurological signssuch as intense tingling in the hands, memory loss, or muscle weaknessthe dosage remains the same (usually 1,000 mcg), but the frequency increases significantly

Reconstituted solutions are generally stored refrigerated at 28C between uses, with the vial itself remaining stable for approximately 28 days post-puncture when handled under sterile laboratory conditions