Cyanocobalamin (B12) Spray

Generic Name: Cyanocobalamin (B12) (SYE-an-oh-koe-BAL-a-min)Brand Name: Nascobal

Cyanocobalamin (B12) Spray is used for:

Maintaining normal vitamin B12 blood levels in certain patients with pernicious anemia. It is also used to treat or prevent low blood levels of vitamin B12 that may be caused by other conditions.

Cyanocobalamin (B12) Spray is a form of vitamin B12. It works by replacing vitamin B12 in the body.

Do NOT use Cyanocobalamin (B12) Spray if:

  • you are allergic to any ingredient in Cyanocobalamin (B12) Spray, including cobalt

Contact your doctor or health care provider right away if any of these apply to you.

Before using Cyanocobalamin (B12) Spray:

Some medical conditions may interact with Cyanocobalamin (B12) Spray. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a runny or stuffy nose, or an upper respiratory tract infection
  • if you have any type of anemia, bone marrow problems, certain eye nerve problems (Leber disease), an infection, a buildup of waste in the blood (uremia), or low blood iron or folic acid levels
  • if you are a vegetarian
  • if you drink alcohol on a regular basis

Some MEDICINES MAY INTERACT with Cyanocobalamin (B12) Spray. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Chloramphenicol, colchicine, or para-aminosalicylic acid because they may decrease Cyanocobalamin (B12) Spray's effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if Cyanocobalamin (B12) Spray may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Cyanocobalamin (B12) Spray:

Use Cyanocobalamin (B12) Spray as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • An extra patient leaflet is available with Cyanocobalamin (B12) Spray. Talk to your pharmacist if you have questions about this information.
  • Cyanocobalamin (B12) Spray is used in the nose.
  • Follow the directions provided by your doctor or other health care provider. If you are unsure how to use Cyanocobalamin (B12) Spray, contact your doctor or other health care provider.
  • Do not use Cyanocobalamin (B12) Spray within 1 hour before or after eating or drinking hot foods or liquids.
  • Prime the pump before the first use. Place the nozzle between the first and second finger with the thumb on the bottom. Point the nozzle away from yourself and others. Pump the unit firmly and quickly until the medicine sprays out, then spray two more times.
  • Re-prime the pump before each dose. Point the nozzle away from yourself and others, then spray once.
  • Use Cyanocobalamin (B12) Spray in only 1 nostril each week.
  • To use Cyanocobalamin (B12) Spray, sit down and tilt your head back slightly. Place the tip of the spray container into the nose. Using a finger from your other hand, press against the opposite nostril to close it off. Breath gently through the open nostril and spray a dose of medicine from the container. After using the medicine, rinse the tip of the spray unit in hot water and dry with a clean tissue to prevent contamination.
  • Cyanocobalamin (B12) Spray is usually used 1 time per week. Do not use it more often than 1 time per week without checking with your doctor.
  • This bottle contains 8 doses. Do not continue to use this bottle after 8 doses have been used. It may not give the correct amount of medicine.
  • Continue to use Cyanocobalamin (B12) Spray even if you feel well. Do not miss any doses.
  • If you miss a dose of Cyanocobalamin (B12) Spray, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Cyanocobalamin (B12) Spray.

Important safety information:

  • Heavy alcohol intake for more than 2 weeks may decrease the effectiveness of Cyanocobalamin (B12) Spray. Check with your doctor if you drink alcohol on a regular basis.
  • Do not substitute folic acid for Cyanocobalamin (B12) Spray without first checking with your doctor. Folic acid may prevent anemia but may not prevent other serious effects such as spinal cord problems.
  • Certain medicines, including antibiotics, methotrexate, or pyrimethamine, may interfere with lab tests for vitamin B12 and folic acid. Be sure your doctor and lab personnel know all the medicines that you are taking.
  • Do not take large doses of vitamins while taking Cyanocobalamin (B12) Spray unless your doctor tells you to.
  • Lab tests, including complete blood cell counts; platelet counts; blood potassium; and blood vitamin B12, iron, and folic acid levels, may be performed while you use Cyanocobalamin (B12) Spray. These tests may be used to monitor your condition or check for side effects. They may be performed every 3 to 6 months. Be sure to keep all doctor and lab appointments.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant while taking Cyanocobalamin (B12) Spray, check with your doctor. You will need to discuss the benefits and risks of using Cyanocobalamin (B12) Spray while you are pregnant. Cyanocobalamin (B12) Spray is found in breast milk. If you are or will be breast-feeding while you are using Cyanocobalamin (B12) Spray, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Cyanocobalamin (B12) Spray:

All medicines may cause side effects, but many people have no, or minor, side effects. When used in small doses, no COMMON side effects have been reported with this product. Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); calf swelling or tenderness; chest pain; irregular heartbeat; muscle weakness or cramping; shortness of breath; swelling of the hands, ankles, or feet; unusual bruising.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects at .

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (, or emergency room immediately.

Proper storage of Cyanocobalamin (B12) Spray:

Store Cyanocobalamin (B12) Spray at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Store upright. Do not freeze. Do not store in the bathroom. Keep Cyanocobalamin (B12) Spray out of the reach of children and away from pets.

General information:

  • If you have any questions about Cyanocobalamin (B12) Spray, please talk with your doctor, pharmacist, or other health care provider.
  • Cyanocobalamin (B12) Spray is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Cyanocobalamin (B12) Spray. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.