update on gp

[jillc39]

neurologist prescribed an extra course of one b12 injection for four weeks. Done, and I feel great. saw gp tonight to ask how I could maintain this and she said I could have 1 b12 injection every month for three months - after that her license means that I have to go onto once every three months regime. Is this right?

[fbirder]

No.

As the neurologist prescribed the B12 jabs I'll assume you have neurological symptoms. The British National Formulary states that hydroxocobalamin is licensed for administration every two months for people with such symptoms. But this is stated in the second paragraph and most doctors seem to stop after reading the first paragraph (the 'every three months' bit).

And doctors are not forced to stick strictly to the licensed uses for a drug. They are allowed to use their own judgement and prescribe outside the remit of the license (called 'off-label') if they believe it would be advantageous to their patient. That's why my GP has prescribed fortnightly jabs.

[jillc39 in reply to fbirder]

oh thank you - very helpful

[Sleepybunny]

Perhaps the GP would like to read page 8 in the BCSH Cobalamin and Folate Guidelines which outlines the recommended B12 treatment for those with and without neurological symptoms.

I'm sure GP will have a copy of BNF (British national formulary) on her bookshelf. Perhaps she would show you the relevant passage (I think it's in Chapter 9 section 1.2) including the second paragraph that fbirder mentions.