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Loading phase (deficiency): 1000 mcg IM or subQ daily or every other day for 1 to 2 weeks Maintenance: 1000 mcg monthly is a standard maintenance dose for conditions like pernicious anemia Wellness protocols: may use lower doses weekly, though this is less established clinically In ml: cyanocobalamin is typically supplied at 1000 mcg/ml, so a 1000 mcg dose equals 1 ml

What payers require for Zepbound prior authorization Zepbound PA requirements are typically more stringent: Documented BMI of 30 or greater, or 27 or greater with at least one weight-related comorbidity Evidence of lifestyle intervention including documented participation in diet, exercise, and behavioral modification programs (usually for at least 3 to 6 months) Prior medication trials (some plans require documented failure of other weight management medications before approving tirzepatide) Specialist involvement (some plans require referral to or management by a bariatric medicine specialist, endocrinologist, or obesity medicine physician) Ongoing weight monitoring documentation with specific weight loss targets (typically 5% of baseline weight within 3 to 6 months of starting therapy) Patients researching BMI requirements for GLP-1 medications should understand that these thresholds directly correspond to the prior authorization criteria their provider must document

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