Tablet: General: Methycobal should not be administered for extensive periods (months) to patients who show no clinical response.
Precautions concerning Use: Caution in handing over drug: For drugs that are dispensed in a press-through package (PTP), instruct the patient to remove the drug from the package prior to use. [It has been reported that, if the PTP sheet is swallowed, the sharp corners of the sheet may puncture the esophageal mucosa, causing perforation and resulting in serious complications such as mediastinitis.]
Other Precautions: Prolonged use of larger doses of Methycobal is not recommended for patients whose occupation requires handling mercury or its compounds.
Injection: METHYCOBAL should not be used aimlessly for more than one month unless it is effective.
Precautions concerning Use: Administration: METHYCOBAL is susceptible to photolysis. It should be used promptly after the package is opened, and caution should be taken so as not to expose the ampoules to direct light.
Intramuscular administration: In intramuscular administration, caution should be exercised, by following the instructions mentioned as follows to avoid adverse effects on tissues or nerves: Avoid repeated injection at the same site. Particular caution should be exercised when administering METHYCOBAL to prematures, neonates, nursing infants and children.
Do not inject in densely innervated site.
If insertion of the injection needle causes intense pain or if blood flows back into the syringe, withdraw the needle immediately and inject at a different site.
Opening the ampoule: METHYCOBAL is supplied in one-point-cut ampoules. The cut point of the ampoules should be wiped with an alcohol swab before opening.