Cyanocobalamin

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Generic Name: Cyanocobalamin Brand Name(s): Generics only. No brands available.

Uses

What is Cyanocobalamin used for?

Cyanocobalamin is commonly used to prevent and treat low blood levels of this vitamin. Most people get enough vitamin B12 from their diet. Vitamin B12 is important to maintain the health of your metabolism, blood cells, and nerves. Serious vitamin B12 deficiency may result in a low number of red blood cells (anemia), stomach/intestine problems, and permanent nerve damage.

Vitamin B12 deficiency may occur in certain health conditions (such as intestinal/stomach problems, poor nutrition, cancer, HIV infection, pregnancy, old age, alcoholism). It may also occur in people who follow a strict vegetarian (vegan) diet.

How should I take Cyanocobalamin?

If you are taking the over-the-counter product to self-treat, follow all directions on the product package before taking this medication. If you have any questions, consult your pharmacist. If your doctor has directed you to take this medication, take as directed by your doctor.

Take this medication by mouth, usually once daily with or without food or as directed by your doctor or the product package. Use this product regularly to get the most benefit from it. To help you remember, take it at the same time each day.

The dosage is based on your medical condition, response to treatment, and laboratory tests. Consult your doctor or pharmacist for more details.

There are many brands and forms of cyanocobalamin (vitamin B12) available. Read the dosing instructions carefully for each product because the amount of cyanocobalamin (vitamin B12) may be different between products.

If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose. Some liquid brands may require you to shake the bottle well before each dose.

If you are taking the extended-release tablets, do not crush or chew them. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split extended-release tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.

If you are taking the chewable tablet, chew the medication thoroughly before swallowing.

If you are taking the rapidly-dissolving tablets, dissolve in the mouth with or without water as directed by your doctor or the product package.

Vitamin C (ascorbic acid) can decrease the amount of vitamin B12 you absorb. Avoid taking large doses of vitamin C within one hour before or after taking this product.

If your condition persists or worsens, or if you think you may have a serious medical problem, seek immediate medical attention.

How do I store Cyanocobalamin?

Cyanocobalamin is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Cyanocobalamin in the bathroom or the freezer. There may be different brands of Cyanocobalamin that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Cyanocobalamin down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Cyanocobalamin?

Before taking cyanocobalamin, tell your doctor or pharmacist if you are allergic to it; or to any form of vitamin B12; or to cobalt; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

If you have any of the following health problems, consult your doctor or pharmacist before using this medication: a certain eye disease (Leber’s optic neuropathy), a certain blood disorder (polycythemia vera), gout, iron or folic acid deficiency anemia, low potassium blood levels (hypokalemia).

Cyanocobalamin taken by mouth should only be used if your body can properly absorb it. You may need a form of vitamin B12 that is injected or inhaled in the nose if you have any of the following health problems: pernicious anemia, food absorption problems, stomach/intestinal surgery (such as gastric bypass or bowel resection), stomach/intestinal disease (such as Crohn’s disease, colitis, diverticulitis, pancreatic insufficiency), irradiation of the small bowel.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Cyanocobalamin is safe to use during pregnancy when taken in recommended doses. Higher doses should be used only when clearly needed. Discuss the risks and benefits with your doctor.

Cyanocobalamin passes into breast milk and is unlikely to harm a nursing infant when used in recommended doses. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Cyanocobalamin during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this Cyanocobalamin. This Cyanocobalamin is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Cyanocobalamin?

This product usually has no side effects. If you have any unusual effects, contact your doctor or pharmacist promptly.

If your doctor has directed you to use this medication, remember that he or she has judged the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

If you have severe anemia, this medication may rarely cause low potassium levels in the blood (hypokalemia) as your body makes new red blood cells. Tell your doctor right away if any of these unlikely but serious side effects occur: muscle cramps, weakness, irregular heartbeat.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Cyanocobalamin?

Some products that may interact with this drug include: drugs that affect the bone marrow (such as chloramphenicol), vitamins/supplements that contain intrinsic factor.

Certain medications can decrease the absorption of vitamin B12, including: colchicine, metformin, extended-release potassium products, antibiotics (such as gentamicin, neomycin, tobramycin), anti-seizure medications (such as phenobarbital, phenytoin, primidone), medications to treat heartburn (such as H2 blockers including cimetidine/famotidine, proton pump inhibitors such as omeprazole/lansoprazole).

Vitamin B12 is an ingredient found in many combination vitamin and nutritional products. Tell your doctor or pharmacist if you are taking other products that contain cyanocobalamin, vitamin B12, or hydroxocobalamin.

Cyanocobalamin may interfere with certain laboratory tests (including intrinsic factor, blood tests for other types of anemia), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

Certain drugs may interfere with laboratory tests for vitamin B12 levels, possibly causing false results. Tell laboratory personnel and all your doctors if you take any of the following: antibiotics (such as amoxicillin, erythromycin), methotrexate, pyrimethamine.

Cyanocobalamin may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Cyanocobalamin?

Cyanocobalamin may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Cyanocobalamin?

Cyanocobalamin may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Cyanocobalamin.

What is the dose of Cyanocobalamin for an adult?

Usual Adult Dose for Pernicious Anemia

Initial dose: 1000 mcg intramuscularly or deep subcutaneous once a day for 6 to 7 days

If clinical improvement and reticulocyte response is seen from the above dosing:

-100 mcg every other day for 7 doses, then:

-100 mcg every 3 to 4 days for 2 to 3 weeks, then:

Maintenance dose: 100 to 1000 mcg monthly

Duration of therapy: Life

Comments:

-Administer concomitant folic acid if needed.

-Chronic treatment should be done with an oral preparation in patients with normal intestinal absorption.

Usual Adult Dose for B12 Nutritional Deficiency

25 to 2000 mcg orally daily

Usual Adult Dose for Schilling Test

1000 mcg intramuscularly is the flushing dose

Other Comments

Administration advice:

-Avoid intravenous administration: almost all of the vitamin will be lost in the urine.

-Warm parenteral solution to body temperature before administration for patient comfort.

Monitoring:

-Pernicious anemia: monitor serum potassium closely during the first 48 hours of treatment and replace potassium if needed.

Patient advice:

-Patients with pernicious anemia will require B12 for the rest of their lives; failure to do so will cause anemia to return, which could lead to incapacitating and irreversible damage to the nerves and spinal cord.

-Taking folic acid instead of B12 may prevent anemia, but allow degeneration of the spinal cord.

What is the dose of Cyanocobalamin for a child?

Usual Pediatric Dose for B12 Nutritional Deficiency

0.5 to 3 mcg daily

How is Cyanocobalamin available?

Cyanocobalamin is available in the following dosage forms and strengths:

  • Injectable solution
  • Nasal gel
  • Oral tablet
  • Nasal spray
  • Compounding powder
  • Sublingual tablet
  • Oral tablet, extended release
  • Intramuscular solution
  • Sublingual lozenge

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Cyanocobalamin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: January 17, 2018 | Last Modified: January 18, 2018

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