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However, even with bacteriostatic water, peptides should not be stored indefinitely after reconstitution

The preserved system facilitates repeated access when standard sterile procedures are followed and supports accurate reconstitution steps for lyophilized materials and calibration series in method development

"Methylcobalamin is the naturally occuring form found in foods, while cyanocobalamin in the synthetic form found in most supplements." Agyeman further explains that cyanocobalamin is commonly found in supplements and food, and the body changes it into active forms

You may be risking permanent joint damage if you don't get a more effective long-term treatment, such as a DMARD.