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The gradual escalation lets the GI tract adapt and dramatically improves tolerability

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The questionnaire consisted of four questions: positive responses were scored as 13 points according to an abnormal degree, and negative responses were scored as 0 points (see Table 1)

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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