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The standard regimen involves: Loading doses without neurological involvement : 1 mg intramuscularly three times a week for 2 weeks [3] [8] Loading doses with neurological involvement : 1 mg intramuscularly on alternate days until no further improvement [3] [8] Maintenance therapy : 1 mg every 23 months for life in cases of pernicious anaemia or irreversible malabsorption (every 2 months if neurological involvement) [3] [8] This aggressive approach aims to prevent irreversible neurological damage, though recovery of established neuropathy may be incomplete, particularly if treatment is delayed

Three authors (MM, AN, and JV) independently screened titles and abstracts following de-duplication

Methylcobalamin should not be used in patients with early hereditary optic nerve atrophy (Lebers disease)

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The Guidelines are not intended as a substitute for the advice or professional judgment of a health care professional, nor are they intended to be the only approach to the management of clinical problem