The amount of cyanocobalamin you need depends on the level of vitamin B12 in your blood and why your levels are low. Your doctor or pharmacist will advise you on what dose to take. If you are taking supplements that you have bought, follow the dosage instructions that come with them.
Swallow prescribed cyanocobalamin tablets whole with a drink of water. Do not chew or break them. This means at least 2 hours after a meal or snack and at least 30 minutes before you eat again. To see how well your tablets are working, your doctor may ask you about symptoms such as tiredness and lack of energy.
You may also have regular blood tests to monitor the levels of vitamin B12 in your blood. Your doctor may want to increase or decrease your dose of cyanocobalamin tablets depending on the level of vitamin B12 in your blood. In this case just leave out the missed dose and take your next one as normal. Never take more than your usual number of tablets at one time.
Never take extra tablets to make up for forgotten ones. If you forget your tablets often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine. In rare cases cyanocobalamin can cause a serious allergic reaction anaphylaxis. These are not all the side effects of cyanocobalamin. For a full list, see the leaflet inside your medicines packet.
You do not usually need to take vitamin B12 supplements when you are pregnant or breastfeeding, unless your doctor has advised you to. You should be able to get all the vitamins you need if you eat meat, fish, eggs, milk and dairy foods. If you notice that your baby is not feeding as well as usual, or if you have any other concerns about your baby, talk to your midwife, health visitor or doctor as soon as possible. Some medicines may reduce the amount of cyanocobalamin you absorb from the tablets or from the food you eat.
This will not usually have a noticeable effect. However, tell your doctor or pharmacist if you are taking any of these medicines:. There is very little information about taking herbal remedies and supplements while taking cyanocobalamin.
Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements. It works by increasing levels of vitamin B12 in your blood. Persons taking most antibiotics, methotrexate and pyrimethamine invalidate folic acid and vitamin B 12 diagnostic blood assays. Colchicine para-aminosalicylic acid and heavy alcohol intake for longer than 2 weeks may produce malabsorption of vitamin B Long term studies in animals to evaluate carcinogenic potential have not been done.
There is no evidence from long-term use in patients with pernicious anemia that cyanocobalamin is carcinogenic. Pernicious anemia is associated with an increased incidence of carcinoma of the stomach, but this is believed to be related to the underlying pathology and not to treatment with cyanocobalamin.
Adequate and well-controlled studies have not been done in pregnant women. However, vitamin B 12 is an essential vitamin and requirements are increased during pregnancy. Amounts of vitamin B 12 that are recommended by the Food and Nutrition Board, National Academy of Science-National Research Council for pregnant women 4 mcg daily should be consumed during pregnancy.
Vitamin B 12 is known to be excreted in human milk. Amounts of vitamin B 12 that are recommended by the Food and Nutrition Board, National Academy of Science-National Research Council for lactating women 4 mcg daily should be consumed during lactation. Intake in children should be in the amount 0.
Pulmonary edema and congestive heart failure early in treatment; peripheral vascular thrombosis. Avoid using the intravenous route. Use of this product intravenously will result in almost all of the vitamin being lost in the urine. Parenteral vitamin B 12 is the recommended treatment and will be required for the remainder of the patient's life. The oral form is not dependable. A dose of mcg daily for 6 or 7 days should be administered by intramuscular or deep subcutaneous injection.
If there is clinical improvement and if a reticulocyte response is observed, the same amount may be given on alternate days for seven doses, then every 3 to 4 days for another 2 to 3 weeks. By this time hematologic values should have become normal. This regimen should be followed by mcg monthly for life.
Folic acid should be administered concomitantly if needed. Where the oral route is not deemed adequate, initial treatment similar to that for patients with pernicious anemia may be indicated depending on the severity of the deficiency. Chronic treatment should be with an oral B 12 preparation.
If other vitamin deficiencies are present, they should be treated. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.
In people with normal absorption, deficiencies have been reported only in strict vegetarians who consume no products of animal origin including no milk products or eggs.
Vitamin B 12 is bound to intrinsic factor during transit through the stomach; separation occurs in the terminal ileum in the presence of calcium, and vitamin B 12 enters the mucosal cell for absorption. It is then transported by the transcobalamin binding proteins. Oral absorption is considered too undependable to rely on in patients with pernicious anemia or other conditions resulting in malabsorption of vitamin B Cyanocobalamin is the most widely used form of vitamin B 12 , and has hematopoietic activity apparently identical to that of the antianemia factor in purified liver extract.
Hydroxycobalamin is equally as effective as cyanocobalamin, and they share the cobalamin molecular structure. Cyanocobalamin is indicated for vitamin B 12 deficiencies due to malabsorption which may be associated with the following conditions:. It may be possible to treat the underlying disease by surgical correction of anatomic lesions leading to small bowel bacterial overgrowth, expulsion of fish tapeworm, discontinuation of drugs leading to vitamin malabsorption see Drug Interactions , use of a gluten-free diet in nontropical sprue, or administration of antibiotics in tropical sprue.
Such measures remove the need for long-term administration of cyanocobalamin. Requirements of vitamin B 12 in excess of normal due to pregnancy, thyrotoxicosis, hemolytic anemia, hemorrhage, malignancy, hepatic and renal disease can usually be met with oral supplementation.
Patients with early Leber's disease hereditary optic nerve atrophy who were treated with cyanocobalamin suffered severe and swift optic atrophy. Hypokalemia and sudden death may occur in severe megaloblastic anemia which is treated intensely.
Anaphylactic shock and death have been reported after parenteral vitamin B 12 administration. An intradermal test dose is recommended before Cyanocobalamin Injection, USP is administered to patients suspected of being sensitive to this drug.
This product contains Benzyl Alcohol. Benzyl Alcohol has been reported to be associated with a fatal "Gasping Syndrome" in premature infants. This product contains aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired.
Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which contain aluminum. Tissue loading may occur at even lower rates of administration. General Precautions: Vitamin B 12 deficiency that is allowed to progress for longer than 3 months may produce permanent degenerative lesions of the spinal cord. Doses of folic acid greater than 0. Neurologic manifestations will not be prevented with folic acid, and if not treated with vitamin B 12 , irreversible damage will result.
Doses of cyanocobalamin exceeding 10 mcg daily may produce hematologic response in patients with folate deficiency.
Indiscriminate administration may mask the true diagnosis. Information for Patients: Patients with pernicious anemia should be informed that they will require monthly injections of vitamin B 12 for the remainder of their lives. Keep all appointments with your doctor and the laboratory.
Your doctor will order certain lab tests to check your body's response to cyanocobalamin injection. It is important for you to keep a written list of all of the prescription and nonprescription over-the-counter medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital.
It is also important information to carry with you in case of emergencies. Generic alternatives may be available. Cyanocobalamin Injection pronounced as sye an oh koe bal' a min.
Why is this medication prescribed? How should this medicine be used? Other uses for this medicine What special precautions should I follow? What special dietary instructions should I follow?
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