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Thanks The Nice guidelines are for NHS prescriptions and based on cost saving re hydroxocobalamin as it was costed in the 1980's

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Vial Duration: Single 10 mg vial lasts 24 days at standard doses

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doi:10.4103/1673-5374.320969 Knezevic M, Gojkovic S, Krezic I, et al

Some mechanistic research relies on non-disease-specific models or tumor cell lines, and the applicability of their conclusions in clinical settings of autoimmune diseases remains to be verified