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A finished copper-peptide serum is light- and oxidation-sensitive and is generally kept refrigerated and used within a short window

Start at 400 micrograms for two weeks

"Nascobal (Cyanocobalamin, USP) Nasal Spray 500 mcg/spray 0.125 mL Rx only" (PDF)

It should be kept in mind that although B12 injections are quite effective, they are not fairy dust

However, when symptoms persist but exacerbate over weeks or months, it could indicate a relatively rare condition named SIRVA, an acronym for Shoulder Injury Related to Vaccine Administration

However, healthy individuals with intact B12 metabolism convert cyanocobalamin efficiently