I am going to check in again here about sub-cutaneous vs. intramuscular injections. My PCP is insisting I need todo IM injecting (“hydroxy should always be IM”) but here I find many do sub-cutaneous and I think I would be very scared to do IM. My husband could probably do it but it still scares me. Is there any physiological advantage to IM that I am missing out as far as absorption, etc. Sorry to say this again but I inject, admittedly, as little as I can as I still don’t sleep (maybe 2 hours/night) for 1-2 days after my injections. I have come a long way in a year, but I know I have a long way to go.
I am very grateful for this forum. It has helped me so much! I would not be self-injecting with the people here.
Thank you.
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IM is totally fine to do - the only bit that ever hurts, if it's going to, is the skin so it makes no difference whether you do SC or IM.
I've always done IM coz it's easier - so long as you stick it in it doesn't matter! 😃 With SC you are supposed to judge how thick your skin is, etc. With you being so tiny you're possibly doing shallow IM without realising.
It's worth trying, just to see if it depots better and releases more slowly - would love to know how you get on.
You can inject Hydroxocobalamin sub-cutaneously if you wish . I get my Hydroxocobalamin B12 ampoules from German online pharmacies . On the packet it states quite clearly that it can be administered Intramuscularly (I.V.) subcutaneously ( sub-cut) or Intravenously( i.V) There’s nothing scary about I.M. I self inject and use that method . I suppose that it looks scary because the needle is longer ! Use the finest ( 25G x1 inch) for I.M and the very finest ( 30G x 1/2 inch) for sub-cut . Best wishes .
I am just constantly wondering if there is any proven advantage to one method over the other. (Especially with my PCP haranguing me over the issue) I find sub-cut extremely easy but I know I could adapt if there was a good reason. No need for you to answer. I appreciate all your knowledge and expertise.
I have never heard of a proven advantage of one method over another. I have been reading posts on this forum for 8 years . I read that sone members do use subcut very successfully. The proof for me was the fact that both methods are recommended on the German packet of Hydroxocobalamin. Now the Germans are not novices where things medical are concerned . So I reckon that either method is fine . The hydroxocobalamin might reach its destination a bit quicker by I.M.
I think it would get into the bloodstream faster and more officiant it that subcu. I just stab my butt. Doesn’t hurt anymore more (in fact less for me) than in my skin. I inject peptides subcu and find IM easier.
I live in the US and my hydroxo is labeled for IM use only. When I was first diagnosed, I received cyano SC, two monthly shots. I was later treated by my primary care physician who administered IM and said it needed to be in the muscle. I learned to self inject IM not long afterwards. I know it seems scary at first but it is really very doable. Once in a while I will hit a nerve and have some slight pain but most of my injections are painless. I became very Ill without injections and the memory of that experience motivates me to keep up with my injections. It’s not something I look forward to every week but I know that I must do it to stay healthy. I do well on hydroxo and since it’s IM injection here, that’s what i do. Since I only had two SC injections one month apart, it’s impossible for me to compare the effectiveness of the two different deliveries. I need frequent injections to keep my symptoms in remission so quick absorption is important to me. Best of luck to you!
Well, that is good to know! There is a Walgreens within 30 minutes of my home. Did you get a vial of 30ml or ampoules? I never even attempted to get B12 at a regular pharmacy because most of them only have cyabocobalamin in vials.
Sorry to butt in, but just to let you know Walmart can also reliably supply you with the Actavis 30mg/mL bottle on prescription. It's a multi-use vial that will give you 30 doses. Info: dailymed.nlm.nih.gov/dailym... It's what my relatives in the US use. I think most pharmacies should be able to get it but some are just not aware of it. They should be able to look it up via the NDC code: 0591-2888-30
Wow, thanks Jade. There is a Walmart in my home town. If I can't get the individual ampoules overseas (which I prefer to be on the safe side) I will check out Walmart for sure.
Yes, it is the 30ml multi-use vial by Actavis and you are correct. Plenty of cyano vials at any pharmacy around. I only learned about it after having it injected at a local private lab. I did so well on it and I had done a little research so I asked my doctor for that exact version and she wrote me a script.
I wish that it came in single use vials like cyano as I think it’s more potent and a better option. Cyano can be injected SC and I find it a more comfortable injection. I think it is for those reasons that it is the preferred choice in the US—more palatable.
With my insurance, hydroxo vial is cheaper than single use cyanocobalamin. It would really be a lot cheaper if one is injecting daily. I only inject weekly, so four doses.
In the US, hydroxo is labeled for IM only. It is also a clinic package so it is not labeled for individual use, but you can obtain is as long as prescribed by a doctor. The pharmacy will usually call the doctor to double check before filling it the very first time just to make sure as it is a clinic package.
Hydroxo is available at other pharmacies and I have also sourced it at CVS but I ran into trouble sourcing it there when I moved. The pharmacist even told me how they obtained it so that I could tell the new pharmacy location how to order it. At CVS, it would have to be ordered through the nearest warehouse by phone, not through their computer system, which showed it wasn’t available.
Very frustrating as the staff at the new location just didn’t understand what I was talking about-they kept saying that the computer says it’s not available . When I couldn’t source it at CVS, I found it at Walgreens through my insurance company. I have sourced it there for the past three years with no problems except for maybe one shortage. There was a really bad shortage several years ago that lasted about 8 months. It was awful and I found myself trying to stretch out the vials. Not recommended! The vials must be tossed after 28 days.
Unfortunately, a lot of pharmacies are not familiar with the hydroxo version, only the cyano version. Like I said, I have also had trouble obtaining it during shortages, but lately that has not been an issue. I pay attention to the expiration dates and this gives me a clue about a possible shortage based on when it was produced.
For me, Walgreens has been the most reliable source. It can also be obtained online through the federal employee program. My mom has sourced it there, but she has had issues with the pharmacist wanting to fill one 30ml vial for 90 days! The fix for this is to just have your doctor specify 3 vials for 90 days. I have never had this issue with CVS or Walgreens-their pharmacists understand the vial must be tossed after 28 days.
There are other options but good luck finding someone who knows what you’re talking about! When you find a reliable source, you will want to stick with that source. Good luck! If I can do IM, anybody can! Hydroxo is worth it for me because I think that I am getting a better version of b12 than cyano. Some people are bothered by the preservatives in the 30ml hydroxo vial, but since I’m not injecting daily, I’m not too concerned.
Also, some users obtain hydroxo at US compounding pharmacies if insurance covers that option. That is what I plan to try in the event of another Actavis shortage. Lots of info but I hope my experience helps you.
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