Generic Name: cyanocobalamin (injection) (sye AN oh koe BAL a min)Brand Names: Cobolin-M, Cyomin, Depo-Cobolin, Vitamin B-12, Vitamin B12
Cyanocobalamin is a man-made form of vitamin B12. Vitamin B12 is important for growth, cell reproduction, blood formation, and protein and tissue synthesis.
Cyanocobalamin is used to treat vitamin B12 deficiency in people with pernicious anemia and other conditions.
Cyanocobalamin may also be used for other purposes not listed in this medication guide.
To treat pernicious anemia, you will have to use this medication on a regular basis for the rest of your life. Not using the medication can lead to irreversible nerve damage in your spinal cord.
Pernicious anemia is also treated with folic acid to help maintain red blood cells. However, folic acid will not treat Vitamin B12 deficiency and will not prevent possible damage to the spinal cord. Take all of your medications as directed.
Your dose needs may change if you become pregnant, if you breast-feed, or if you eat a vegetarian diet. Tell your doctor about any changes in your diet or medical condition.If you have any of these other conditions, you may need a dose adjustment or special tests to safely use cyanocobalamin injection:
any type of infection;
iron or folic acid deficiency;
kidney or liver disease; or
if you are receiving any medication or treatment that affects bone marrow.
Use this medication exactly as prescribed by your doctor. Do not use it in larger amounts or for longer than recommended. Follow the directions on your prescription label.
Your dose needs may change if you become pregnant, if you breast-feed, or if you eat a vegetarian diet. Tell your doctor about any changes in your diet or medical condition.The injection form is given as a shot into a muscle or under the skin. Your doctor, nurse, or other healthcare provider will give you this injection. You may be shown how to inject your medicine at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes.
Use each disposable needle only one time. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.
To be sure this medication is helping your condition, your blood will need to be tested every 3 to 6 months. This will help your doctor determine the correct dose and how long to treat you with cyanocobalamin. Do not miss any scheduled appointments.
To treat pernicious anemia, you will have to use this medication on a regular basis for the rest of your life. Not using the medication can lead to irreversible nerve damage in your spinal cord.
Pernicious anemia is also treated with folic acid to help maintain red blood cells. However, folic acid will not treat Vitamin B12 deficiency and will not prevent possible damage to the spinal cord. Take all of your medications as directed.
Store this medication at room temperature away from moisture, heat, and light.Call your doctor for instructions if you miss a dose.
chest pain;
feeling short of breath, even with mild exertion;
swelling, rapid weight gain; or
unusual warmth, redness, or pain in an arm or leg.
Less serious side effects may include:
headache, dizziness, weakness;
nausea, upset stomach, diarrhea;
numbness or tingling;
pain, swelling, redness, or irritation where the injection was given;
fever;
joint pain; or
itching or rash.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.
Usual Adult Dose for Pernicious Anemia:
Parenteral:Initial dose: 100 mcg intramuscularly once a day for 7 days. If there is clinical improvement and a reticulocyte response, 100 mcg intramuscularly once every other day for 7 days, then once every 3 to 4 days for another 2 to 3 weeks is recommended. Most patients require monthly injections of 100 to 1000 mcg intramuscularly for life.Nasal Spray or Gel:Alternatively, cyanocobalamin (Nascobal) nasal spray or nasal gel 500 mcg intranasally to one nostril once a week may be administered to patients with pernicious anemia who require maintenance of normal hematologic status following intramuscular vitamin B12 and who have no nervous system involvement. However, if the patient is not adequately maintained with cyanocobalamin nasal, intramuscular vitamin B12 administration must be resumed.
Usual Adult Dose for B12 Nutritional Deficiency:
Oral: 25 to 250 mcg once a day.Nasal Spray or Gel: (Nascobal) 500 mcg intranasally in one nostril once a week(CaloMist) 25 mcg in each nostril once a day (total dose 50 mcg). May be increased to 50 mcg in each nostril once a day.
Usual Adult Dose for Schilling Test:
1 mcg radiolabeled cyanocobalamin orally once after urinary voiding. A 24-hour urinary collection is immediately begun. At 2 hours an injection of cyanocobalamin 1,000 mcg intramuscularly is given to "flush" the patient of absorbed radiolabeled drug. The percentage of radiolabeled B12 excreted in the urine is a measure of how much labeled drug was absorbed. Normally 7% or more of a dose is excreted in 24 hours (< 7% may be considered a positive Schilling test).
Usual Pediatric Dose for Pernicious Anemia:
30 to 50 mcg/day for 2 or more weeks (to a total dose of 1000 to 5000 mcg), then follow with 100 mcg/month.
Usual Pediatric Dose for B12 Nutritional Deficiency:
100 mcg/day for 10 to 15 days (total dose of 1 to 1.5 mg), then once or twice weekly for several months. May taper to 60 mcg every month.
Before using cyanocobalamin, tell your doctor if you are taking any of the following medications:
antibiotics;
methotrexate (Rheumatrex);
pyrimethamine (Daraprim);
colchicine; or
if you drank a lot of alcohol within the past 2 weeks.
This list is not complete and there may be other drugs that can interact with cyanocobalamin. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.