Manufacturer recommendations

[MorningMist]

I’ve just read and compared the manufacturer instructions for Hevert and Pascoe.

Hevert - first few weeks 1ml (500mcg) twice weekly followed by 100mcg per month. Discard remaining b12 in ampoule.

Pascoe initially 1500mcg twice weekly, also followed by monthly dose of 100mcg. So 1/15th of an ampoule!

It seems odd that nowhere does Hevert advise to inject a full ampoule and the small monthly maintenance dose for both brands is just a fraction of the amount supplied.

Both do say unless otherwise specified by a doctor, but it’s surprising all the same.

[Nackapan]

Do seem odd dose instructions. I wonder what based on .

I wonder if the 100 is 1mg ?

[MorningMist in reply to Nackapan]

I did wonder that but both state 100mcg so not likely to be a misprint.

[Nackapan in reply to MorningMist]

Very odd as no ampoules made with so little

[am111 in reply to Nackapan]

100mcg/month is considered maintenance dose by some, although others say 1000mcg/month. This is for cyanocobalamin. As hydroxy is absorbed more, the maintenance dose could be 100mcg/month. B12 is cheap, so it may not make economic sense to produce ampoules of multiple strengths.

[MorningMist in reply to am111]

That makes sense. I was aware that Hevert advised loading doses equivalent to half an ampoule but not that the maintenance dose was just 100mcg.

[am111 in reply to MorningMist]

We only need 1-2mcg/day, so this is where it comes from. There are papers that say that 100mcg cyanocobalamin injection lasts for 31 days, 1000mcg for 43 days and 10000mcg for 49 days only . Thats how the 1000mcg/month recommendation for cyanocobalamin comes from. Only some 55-75mcg of a 100mcg cyanocobalamin is retained, so 100mcg/month for hydroxy seems reasonable.

[Flintfootfilly]

I have heard some people say the frequency of jabs was more significant to their symptom reduction than the dose.

[wedgewood in reply to Flintfootfilly]

Yes , I’ve heard that too , and it was from someone who had good knowledge of Pernicious Anaemia. I mg is a large dose . But as it was said , producing smaller ampoules would probably be expensive.

[MorningMist in reply to wedgewood]

And extremely difficult to open..😄

[MorningMist in reply to Flintfootfilly]

Yes and both brands state monthly rather than our standard nhs 3 months. Maybe that’s the rationale behind it.

[Rosydawn]

I recently looked at the Panpharma in German and also they say the same …ie 100 not 1000.

[MorningMist in reply to Rosydawn]

Yes it’s interesting that even the manufacturers do not acknowledge the wide variation in the amount required by some people. Maybe it is covered by the statement ‘unless otherwise directed by a doctor’.