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Liver/Kidney/CYP450: High-dose systemic copper chelate therapy requires strict monitoring of ceruloplasmin and unbound serum copper to prevent heavy metal toxicity or Wilson-like hepatic accumulation

During the loading phase , patients typically receive 1mg of hydroxocobalamin intramuscularly three times per week for two weeks (six injections total)

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It can be self-administered at home or done in a clinic setting

Particular attention is warranted for diverse populations, including older adults, individuals with advanced renal disease, pregnant patients, and those at risk of lean mass loss during rapid weight reduction