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Once patients reach 2.4 mg per week and have stabilized there for several months, the focus shifts from escalation to consistency

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The elevated B12 appears to be a consequence of disease activity, likely resulting from increased production of B12-binding proteins by tumor cells or from liver involvement in the cancer process

After at least 30 days on the 7mg dose, further dose escalation to 14mg once daily may be considered if additional glycaemic control is required and the medication has been well tolerated

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