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The medication should be protected from excessive heat and humidity, which can accelerate degradation and potentially support microbial growth

Applied and Environmental Microbiology

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In the UK, hydroxocobalamin is the standard form used for intramuscular injections, and routine monitoring of serum B12 levels during replacement therapy is generally not required once treatment is established

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The MHRA recommends considering periodic B12 monitoring in patients on metformin who have risk factors for deficiency, and testing if symptoms develop