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I read a report of an assessment of medicines and expiry dates a couple of years ago

Studies published in Biochemical Pharmacology show that NNMT expression increases significantly with aging in skeletal muscle tissue and correlates with impaired muscle stem cell function and reduced regenerative capacity

Potential effects on methylation pathways and NAD+ metabolism should be considered

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The dosing regimen varies depending on whether neurological symptoms are present: With neurological involvement: 1 mg intramuscularly on alternate days until no further improvement, then 1 mg every 2 months [3] [4] Without neurological involvement: 1 mg intramuscularly three times a week for 2 weeks, then 1 mg every 2-3 months for maintenance [3] [4] There is some evidence that high-dose oral B12 (1000-2000 micrograms daily) may be effective even in some malabsorption conditions, though UK practice still generally favours intramuscular treatment in these cases