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Nature 440 , 944948 (2006)

If numbness or tingling in the hands persists beyond 2 weeks, reduce the dose by 50% and reassess

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While I have never used expired b12 vials since a pharmacist told me not to I have used multi-use vials after 28 days when they are supposed to be discarded and unrefrigerated once opened as well

As someone who has analyzed pharmacy expenditures for the past 20 years, mainly in the Medicare space, it is tempting to default to the thought process that commercial plans shouldnt pay for GLP-1s for weight loss until Medicare does