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Dosing information Usual Adult Dose for Pernicious Anemia: Initial dose: 100 mcg intramuscularly or deep subcutaneous once a day for 6 to 7 days If clinical improvement and reticulocyte response is seen from the above dosing: 100 mcg every other day for 7 doses, then: 100 mcg every 3 to 4 days for 2 to 3 weeks, then: Maintenance dose: 100 to 1000 mcg monthly Duration of therapy: Life Comments: Administer concomitant folic acid if needed

Animal model research demonstrated that depleting GSH via inhibition of GCL triggered a cascade of lipid peroxidation and cell death in mesencephalic cultures, identifying oxidative stress from glutathione insufficiency as a likely initiating mechanism in neurodegeneration

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Oral capsules and liquids must fight their way through stomach acids and liver enzymes, resulting in a microscopic absorption rate of only 1% to 10%