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A reasonable titration schedule might look like this: Week 1: 200mcg once daily Week 2: 300mcg once daily Week 3 onward: 300-500mcg based on response and tolerance Optimizing injection technique Poor injection technique contributes to injection site reactions and potentially to other effects like nausea from anxiety around the process

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Alexander Leung: nothing to disclose

Treatment of certain inherited disorders: Some inherited metabolic disorders, such as methylmalonic acidemia and homocystinuria, may benefit from hydroxocobalamin treatment due to its role in converting methylmalonyl-CoA to succinyl-CoA and facilitating the conversion of homocysteine to methionine