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Pernicious Anaemia Society

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Cannot access British National Formulary from US

Holnee profile image
5 Replies

Hello, I cannot access the British National Formulary from the US. Is there someone who would be kind enough to post the passage regarding treatment for neurological symptoms continuing until there is no further improvement? Thank you in advance!

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Holnee profile image
Holnee
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Polaris profile image
Polaris

bcshguidelines.com/4_HAEMAT...

Then go to page 4 - B12 Deficiency:

onlinelibrary.wiley.com/sto...

"Treatment of cobalamin deficiency

Current clinical practice within the UK is to treat cobalamin deficiency with hydroxocobalamin in the intramuscular form

(outlined in the British National Formulary, BNF, medicinescomplete.com/mc/bn... used-in-megaloblastic-anaemias.htm).

Standard initial ther- apy for patients without neurological involvement is 1000 lg intramuscularly (i.m.) three times a week for 2 weeks. The BNF advises that patients presenting with neurological symp- toms should receive 1000 lg i.m. on alternate days until there is no further improvement. "

Also

Page 4 under parental treatment

cmim.org/pdf2014/funcion.ph...

humanbean profile image
humanbean

I'm not sure if this is what you were after - and without formatting it will be hard to read. I've bolded the bit I think is important :

HYDROXOCOBALAMIN



Previous

Next

Additional information interactions (Hydroxocobalamin).

Indications

see under dose below; cyanide poisoning (see Emergency Treatment of Poisoning)

Cautions

should not be given before diagnosis fully established but see also Prescribing notes (drugs used in megaloblastic anaemias); interactions: Appendix 1 (hydroxocobalamin)

Breast-feeding

present in milk but not known to be harmful

Side-effects

nausea, headache, dizziness; fever, hypersensitivity reactions (including rash and pruritus); injection-site reactions; hypokalaemia and thrombocytosis during initial treatment; chromaturia

Dose

By intramuscular injection, pernicious anaemia and other macrocytic anaemias without neurological involvement, initially 1 mg 3 times a week for 2 weeks then 1 mg every 3 months

Pernicious anaemia and other macrocytic anaemias with neurological involvement, initially 1 mg on alternate days until no further improvement, then 1 mg every 2 months

Prophylaxis of macrocytic anaemias associated with vitamin B12 deficiency, 1 mg every 2–3 months

Tobacco amblyopia and Leber's optic atrophy, initially 1 mg daily for 2 weeks, then 1 mg twice weekly until no further improvement, thereafter 1 mg every 1–3 months

CHILD see BNF for Children

clivealive profile image
clivealiveForum Support

Hi Holnee

Treatment of cobalamin deficiency

"Current clinical practice within the U.K is to treat cobalamin deficiency with hydroxocobalamin in the intramuscular form outlined in the British National Formulary, BNF,

Standard initial therapy for patients without neurological involvement is 1000 μg intramuscularly (i.m.) three times a week for two weeks.

The BNF advises that for Pernicious anaemia and other macrocytic anaemias patients presenting with neurological symptoms should receive 1000 μg i.m. on alternative days until there is no further improvement.

However, the GWG recommends a pragmatic approach in patients with neurological symptoms by reviewing the need for continuation of alternative day therapy after three weeks of treatment"

Gambit62 profile image
Gambit62Administrator

The guidelines are actually produced by the British Committee for Standards in Haematology. The BNF - British National Formulary which is a UK pharmaceutical reference book.

Hope you have managed to get what you needed from the responses below

Holnee profile image
Holnee

Thank you all! It turns out I didn't need this information for my appt. with the neurologist today. I expected to need to convince him to continue to treat me, but he was more than willing. I still have some work to do, but I feel like my team is receptive and things are headed in a good direction. I really appreciate your help, and I know this information will come in handy at some point, so I am very grateful to have it. Thank you!

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