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These letters appear to be indiscriminate cost saving initiatives and are being sent out as individual practice directives and not that of the CCG (Clinical Commissioning Group)

Hydroxocobalamin Cyanocobalamin and hydroxocobalamin are the two main types of Vitamin B12 used in injections

Prescribers should be aware that hydroxocobalamin is contraindicated in patients with a known hypersensitivity to cobalt or any other component of the injection solution

Methylated B12 refers to a form of vitamin B12 that has been chemically altered to include a methyl group, making it more readily absorbed and utilized by the body, especially for those with certain genetic mutations affecting B12 metabolism