Brands of hydrox b12 for SC

[Nackapan]

Pharmacist got back to me. They can't order Roxexmedica.

Wavylines as you get it prescribed n the NHS what brand is it please. The pharmacist said he would order it if I find a brand.

At the moment as having b12 injections at GP surgery I want to try SC there first. The Gp has agreed but nurses csnt do it with current brand. . Maybe all hydrox in uk is for IM usd only ad Fbirder says . All so frustrating .

Thanks for any info on brand

[fbirder]

My latest batch from the NHS was by Accord Healthcare. It is made by Rotexmedica.

[Nackapan in reply to fbirder]

Thank you

[Gambit62 Administrator]

The patient advice leaflet for the UK may say IM only and not mention SC as a delivery method. If you source the same product from Germany the leaflet is likely to mention both IM and SC (albeit in German)

[Nackapan in reply to Gambit62]

Thank you most helpful

[Wagonwheel]

Latest NHS batch also Accord Healthcare.

[Foggyme Administrator]

Nackapan.

Hydroxocobalamin is not licensed for SC injection in the U.K.

Here's a link to the BNF prescribing instructions (this applies to all brands of hydroxocobalamin, whatever the manufacturer or country of origin):

bnf.nice.org.uk/drug/hydrox...

Even if you buy a brand from German that states on that patient information leaflet that it is suitable for SC injection, this applies to licensing in that country. This does not mean that it is licensed for SC injection in the U.K.

In other words, licensing in the U.K. is not brand specific - buying a different brand will not circumvent UK licensing arrangement.

This is not because it's not safe for SC injection...just that it has never been licensed for that form of use, in the U.K.

It's therefore unlikely that either a GP or a surgery nurse will countenance SC injections. Doing so would involve them having to prescribe 'off-licence' and most would not be prepared to do this.

My understanding is that the PAS and involved in research into SC delivery of vitamin B12 ...but the U.K. is still a long from the point off actually licensing it for SC injection.

Some here do self-inject B12 subcutaneously...and it's likely (but not yet proven by research) that this is an effective means of delivery.

You may have more luck if you ask your surgery to teach you to do your own IM injections, since they would not have to prescribe off-licence to do so. Some are happy to do that...some are not (though goodness knows why since many people are taught IM injection techniques for other medications).

Hope you find a solution that works for you.

[Nackapan]

Yes. The Gp was happy for me to try Sc. After reading up on it. It was more the nurse (which i understand) coukdnt give it. I asked to do it myself at the start inbetween Im by the nurse.

Its odd isnt it that so many drugs are used 'off licence' on a daily basis

Thanks for reply

[Bellabab]

My NHS hydroxocobalamin has the name of Neo-Cytamen and is made by RHP Pharamceuticals AB , Sweden. Printed on the packet it says "For intramuscular use". I inject myself into a muscle - it is very easy to do and only slightly painful now and again. It is easy to get used to this low pain level.

Intramuscular injection means the B12 gets into the blood stream much faster than with subcutaneous injections - thats what we need. Absorption from a subcutaneous jab can be very inconsistent.

[fbirder in reply to Bellabab]

Just two points -

First, Nobody knows which gets the B12 into the bloodstream faster. Different drugs distribute at different rates from different tissues and it’s not possible to make definite predictions. And nobody ever seems to have done the experiment.

You would think that IM would get it into the blood faster as muscle is more highly vasculated (has more blood vessels). But B12 is very water soluble and should move quite easily between the fat cells when given subcutaneously. I’d be surprised if there was much difference between the two. About 3 hours for most of the dose to get into the blood is probably about correct.

Secondly, if there is a difference then the one that gets the B12 into the blood slowest would be best. B12 is eliminated in the urine. The higher the amount, the more is eliminated. So having he B12 slowly dribble into the blood will result in lower concentrations, less getting excreted in the urine and, therefor, more being stored.

But, as I said, I have no reason to believe that there is going to be any significant difference.

[Nackapan in reply to fbirder]

Thank you for clarification .

The Gp thought the same.

I've read same.

[Nackapan]

Thankyou for the information.

I dont intend to give up thd IM injections but wanted to trial a sc top up I could do. My arms are stiff and sore. I do relax for the nurse.