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Temperature mishandling Adding cold water to cold powder slows dissolution and may not fully hydrate the lyophilized structure

At the beginning of the treatment, 1 ampoule with 1 mlvitamin B 12 Lichtenstein (corresponding to 1000 micrograms of cyanocobalamin) is added twice a week in the first weeks after diagnosis.12 Lichtenstein is usually administered intramuscularly (injected into a muscle)

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Warnings Patients with early Leber's disease (hereditary optic nerve atrophy) who were treated with cyanocobalamin suffered severe and swift optic atrophy