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Storage above 25C shortens it further, to around 7 days

Do not use folic acid instead of vitamin B12

Mild side effects and potential risks, which should be referred to a doctor if they persist or worsen, include: pain, redness, or itching at the site of the injection mild diarrhea swelling sensation in the body More serious side effects, which require immediate medical attention, include: muscle cramps irregular heartbeat unusual weakness or tiredness swelling of the ankles or feet Severe reactions are very rare but require emergency intervention

Patients should be educated about the importance of maintaining treatment adherence, as discontinuation leads to recurrent deficiency within months to years

A common guideline for opened multi-dose vials is to date the vial when first accessed and discard within 28 days unless the manufacturer states another timeframe