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Vitamin B12 (Cyanocobalamin)

    Brands

    DEA Class; Rx

    Common Brand Names; vitamin B12, Nascobal, Athlete, Calomist, cobalamin, Cobex, Crystamine, Prime, Rubramin PC, Vibisone, Eligen B12

    • B Vitamins; 
    • Vitamins, Water-Soluble

    Nasal/oral/parenteral B vitamin
    Used to treat pernicious anemia and prevent and treat vitamin B12 deficiency, as well as to determine vitamin B12 absorption in the Schilling test
    Equal in biologic activity to hydroxocobalamin

    Indicated for nutritional supplementation.

    For the treatment and prevention of vitamin B12 deficiency or for the treatment of vitamin B12 deficiency megaloblastic anemia or macrocytic anemia thought to be due to vitamin B12 deficiency.
    For the treatment of pernicious anemia.
    For vitamin B12 deficiency diagnosis.
    For the treatment of methylmalonic aciduria.

    Hypersensitivity to product; sensitivity to cobalt

    • Arthralgia (12%)
    • Dizziness (12%)
    • Headache (12%)
    • Nasopharyngitis (12%)
    • Anaphylaxis
    • Angioedema
    • Congestive heart failure
    • Peripheral vascular disease
    • Pulmonary edema
    • Diarrhea
    • Dyspepsia
    • Polycythemia vera
    • Sore throat
    • Nervousness
    • Rhinitis
    • Glossitis
    • Hypoesthesia

    Intensive treatment of B12-deficient megaloblastic anemia may cause hypokalemia and sudden death; monitor serum potassium and platelet counts more frequently in these patients

    Nasal disease; defer use until symptoms resolve

    Injection is incompatible with some common drugs (eg, warfarin and several phenothiazines) but is compatible with vitamins B and C

    Vitamin B12 deficiency for >3 months results in irreversible degenerative CNS lesions

    Thrombocytosis may occur with treatment of severe vitamin B12 megaloblastic anemia

    Oral and intranasal route are not indicated for the treatment of pernicious anemia until symptoms resolve

    Vitamin B12 deficiency masks signs of polycythemia vera; vitamin B12 administration may unmask condition; patients exhibiting clinical or hematologic response consistent with polycythemia vera should be referred for further evaluation

    IM and SC route used to treat pernicious anemia; oral and intranasal not indicated until hematologic remission and no signs of nervous system involvement

    Parenteral product may contain aluminum; toxic aluminum concentrations may occur with renal dysfunction, high doses, or prolonged use

    Efficacy of intranasal administration in patients with nasal pathology or concomitant therapy has not been determined; use with caution

    Administration of approved recommended dose is not expected to cause major birth defects, miscarriage or adverse maternal or fetal outcomes

    Vitamin B12 is present in human milk; administration of approved recommended dose is not expected to cause harm to a breastfed child

    Upper tolerable intake levels in healthy, non-vitamin deficient individuals are not determinable due to a lack of data.

    Cyanocobalamin 

    tablet

    • 100mcg
    • 250mcg
    • 500mcg
    • 1000mcg

    tablet, extended release

    • 1000mcg

    tablet, sublingual

    • 2500mcg

    injectable solution

    • 1000mcg/mL

    nasal spray

    • 500mcg/spray