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There are no other absolute contraindications reported for hydroxocobalamin use in deficiency states, but caution is advised in individuals with conditions such as early Lebers optic neuropathy (a rare hereditary optic atrophy) due to the theoretical risk of worsening vision

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Standard AOD-9604 Dosing Protocol Subcutaneous Injection Dosing: Beginner: 250 mcg per dose, once daily Intermediate: 300-400 mcg per dose, once daily or divided into two doses Advanced: 500 mcg per dose, once daily or 250 mcg twice daily Oral Administration Dosing (if using oral formulation): Standard: 1-2 mg per dose, once daily on empty stomach Higher protocols: Up to 5-10 mg daily, as studied in clinical trials Frequency: Once daily (morning preferred) or twice daily (morning and early afternoon) Timing: Best administered on an empty stomach, typically upon waking or before exercise Cycle Length: 12-16 weeks for initial assessment, with potential for longer protocols based on response Off Cycle: 4-8 weeks between cycles, though not strictly required based on current research Note: Start at the lower end of the dosing range to assess individual tolerance