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5 Ketamine is thought to mitigate pain, at least partly, through its complex interaction with mu and kappa opioid receptors, although ketamine affinity for these receptors is almost tenfold less than for the NMDA channel

However, providers in clinical or wellness settings may use examples such as: 600 mg intramuscularly once per week Two injections of 300500 mg spaced out during the week 10001200 mg intravenously in supervised wellness programs These examples are informational only

The MHRA advises checking B12 levels in patients on metformin who have symptoms of deficiency or risk factors, and considering periodic monitoring

Kornblau S, Benson AB, Catalano R, Champlin RE, Engelking C, Field M, Ippoliti C, Lazarus HM, Mitchell E, Rubin J, Stiff PJ, Vokes E, Wadler S