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The standard-of-care for symptomatic patients usually includes an initial phase (around 2-6 months) of copper chelation with agents, such as penicillamine or trientine (triethylenetetramine), followed by lifelong maintenance therapy with penicillamine and/or trientine and/or zinc salts (107)

Hedstrom M Article: BMC GERIATRICS

Due to the half-life of the dsRNA, the effectiveness of RNAi gradually weakens with an increasing length of time after treatment, so there may be a discrepancy in the life events (such as laying and hatching of eggs) after engorgement of ticks

In the case of severe vitamin B12 deficiency, consider discussing with your physician whether vitamin B12 injections can be an appropriate option