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Replace the pen body if the dial mechanism feels loose, skips clicks, or does not return to zero after a full injection

PMID: 40935835 Cheng J et al

Discontinuation due to adverse events was 5.9% in REDEFINE 1 and 8.4% in REDEFINE 2

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Results showed a significant lack of knowledge, with 80% of nurses unfamiliar with the definition, 83.3% unaware of causes and symptoms, and 90% lacking knowledge on pain management

Studies directly comparing the two forms note that up to three times as much cyanocobalamin is excreted in the urine compared to methylcobalamin