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Compounded semaglutide is generally safe for up to 28 days after the vial is first punctured, as long as it is stored properly in the refrigerator

Methylcobalamin B12 An active form of vitamin B12 that helps convert fats and carbohydrates into energy while supporting metabolism, blood cell production, and proper nerve health

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Initial treatment for patients with neurological involvement follows British National Formulary (BNF) guidance: Hydroxocobalamin 1 mg intramuscularly on alternate days for approximately 2-3 weeks (or until no further improvement) Maintenance therapy then consists of hydroxocobalamin 1 mg intramuscularly every two months Hydroxocobalamin is preferred over cyanocobalamin in the UK due to superior retention and fewer injections required

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