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While the above guidelines offer a general framework, your specific situation may require a different approach

Drop back to the last tolerated dose and stay there for 6-8 weeks before attempting escalation again

This complex process means that conditions affecting the stomach or intestines can significantly impair B12 absorption, including pernicious anaemia, atrophic gastritis, previous gastric surgery, coeliac disease, Crohn's disease, and long-term use of certain medications (such as metformin, proton pump inhibitors, and H2 antagonists)

Are there any side effects of Methylcobalamin Injection

However, it is essential to consult healthcare professionals to determine the right course of treatment based on individual health needs

Nasal spray: 500 mcg/0.1 mL (per actuation), packaged in a single-use device containing 0.125 mL of solution Cyanocobalamin Nasal Spray is contraindicated in patients with hypersensitivity to cobalt and/or vitamin B12 or any of its excipients [see Warnings and Precautions (5.2)]