b12 injection pen uk self China Manufacturers Suppliers Factory Exporter Patients self-injecting vitamin B12 without

Long-term use of proton pump inhibitors and metformin can impair B12 absorption, necessitating monitoring or parenteral therapy

Our clinicians need reminding that Pernicious anaemia (PA) is the very tip of a huge iceberg

Options include: Changing from one oral tablet formulation to another with different excipients Discussing sublingual preparations as an alternative (though evidence doesn't suggest superior absorption to oral tablets) For those on injections, checking the specific product's SmPC for excipient information In the UK, hydroxocobalamin injection is the licensed first-line treatment for B12 deficiency requiring parenteral therapy

The PA is trained on the procedure and has competency