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After a single hydroxocobalamin injection, therapeutic levels can be maintained for approximately 8 to 12 weeks in most patients, which aligns with the standard maintenance schedule of injections every 2-3 months recommended in the British National Formulary (BNF)

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This is often manifested as bluish skin discoloration and impaired mental function resulting from compromised brain circulation [3]

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This makes it safe for use in topical applications and other therapeutic treatments