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Hydroxocobalamin is a prescription-only medicine (POM) that should be administered by appropriately trained healthcare professionals, typically following a standard regimen of loading doses (e.g., 1mg on alternate days for 1-2 weeks) followed by maintenance doses (1mg every 2-3 months, or every 2 months if neurological symptoms are present)

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Ketosis may also be induced by prolonged fasting or severe caloric restriction

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A prescription is not guaranteed the physician makes the final determination