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Prescription and administration: Once B12 deficiency is confirmed, GPs prescribe hydroxocobalamin injections according to standardised protocols: Standard loading regimen: 1mg intramuscularly three times weekly for two weeks Neurological involvement: 1mg intramuscularly on alternate days until no further improvement Maintenance therapy: 1mg every three months for life in pernicious anaemia or malabsorption conditions (or every two months if there was neurological involvement) Injections are typically administered by practice nurses at GP surgeries

Structural differences: In AHK-Cu (Ala-His-Lys:Cu(II)), the alanine methyl group introduces greater lipophilicity and steric bulk near the N-terminal copper coordination site

This is the only way I've seen it spelled out clearly in one place

Its considered a strong relative precaution, not necessarily an absolute contraindication for everyone