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After that initial period, it is common to continue injections monthly, though less frequent intervals might be OK if cobalamin blood levels are supportive

Mixed treatment comparison of dronedarone, amiodarone, sotalol, flecainide, and propafenone, for the management of atrial fibrillation

Definitive diagnosis can be confirmed with skin biopsy that typically shows any of the following: Evidence of neutrophilic infiltration within and around the vessel wall with the signs of clear dust or leukocytoclasia (disintegration of neutrophil nuclei into fragments) Fibrinoid necrosis or fibrin deposition within and around the vessel wall Signs of damage to the vessel wall and surrounding tissue such as damaged endothelial cells or extravasated red blood cells

But many also continued, most commonly by asserting the clinical need exception for a personalized version of the products, much to the frustration of the FDA and brand manufacturers

Annu Rev Pharmacol Toxicol 2005