Cyanocobalamin Injection

Drug overview for CYANOCOBALAMIN INJECTION (cyanocobalamin (vitamin b-12)):

Generic name: CYANOCOBALAMIN (VITAMIN B-12) (SYE-an-oh-koe-BAL-a-min)
Drug class: Cobalamines
Therapeutic class: Electrolyte Balance-Nutritional Products

Vitamin B12, a cobalt-containing B complex vitamin, is commercially available as cyanocobalamin and hydroxocobalamin, which are synthetic forms of vitamin B12. Hydroxocobalamin (Cyanokit(R)) is an antidote for cyanide poisoning.

No enhanced Uses information available for this drug.

DRUG IMAGES

CYANOCOBALAMIN 1,000 MCG/ML VL
CYANOCOBALAMIN 30,000 MCG/30ML
CYANOCOBALAMIN 10,000 MCG/10ML

The following indications for CYANOCOBALAMIN INJECTION (cyanocobalamin (vitamin b-12)) have been approved by the FDA:

Indications:
Pernicious anemia
Prevention of vitamin B12 deficiency
Vitamin B12 deficiency

Professional Synonyms:
Addison's anemia
Addison-Biermer disease
Addisonian anemia
Addisonian pernicious anemia
Anemia due to cyanocobalamin deficiency
Biermer's anemia
Biermer's disease
Cyanocobalamin deficiency
Macrocytic achylic anemia
Malignant anemia
Primary anemia

The following dosing information is available for CYANOCOBALAMIN INJECTION (cyanocobalamin (vitamin b-12)):

Dosing
Administration
CYANOCOBALAMIN INJECTION
CYANOCOBALAMIN INJECTION

For the treatment of pernicious anemia, the usual initial IM or subcutaneous dosage of cyanocobalamin is 100 mcg daily for 6-7 days. If clinical manifestations have improved and a reticulocyte response is observed, cyanocobalamin can then be administered in a dosage of 100 mcg every other day for 7 doses and then 100 mcg every 3-4 days for 2-3 weeks. Once hematologic values have returned to normal, cyanocobalamin can be administered IM or subcutaneously in a dosage of 100 mcg once monthly for life.

Folic acid should be used concomitantly if necessary.

For the treatment of vitamin B12 deficiency in adults, the usual IM dosage of hydroxocobalamin is 30 mcg daily for 5-10 days. Once clinical symptoms have subsided and the blood components have returned to normal, monthly IM maintenance doses of 100-200 mcg appear to be sufficient to maintain a normoblastic bone marrow. For the treatment of vitamin B12 deficiency in children, the usual total IM dose of hydroxocobalamin is 1-5 mcg over 2 or more weeks, given in single doses of 100 mcg.

For maintenance, the IM or subcutaneous pediatric dosage is at least 60 mcg per month; however, smaller doses may often suffice for deficiency states not caused by pernicious anemia.

The commercially available cyanocobalamin metered-dose pump delivers 0.1 mL of solution containing 500 mcg of the drug per actuation. The recommended initial dosage of cyanocobalamin nasal spray is 500 mcg (one actuation) administered intranasally once weekly.

The dosage may need to be increased in patients who experience a decline in serum vitamin B12 concentrations after 1 month of therapy with this preparation. Therapy with a parenteral vitamin B12 preparation may be necessary in patients who do not achieve a satisfactory response to intranasal cyanocobalamin.

Cyanocobalamin is administered by IM or deep subcutaneous injection. Cyanocobalamin also is administered orally and intranasally. Hydroxocobalamin is administered by IM injection or IV infusion. Oral therapy with vitamin B12 preparations is markedly inferior to parenteral therapy and should be used only for the treatment of dietary vitamin B12 deficiency in patients with normal GI absorption.

Dosing information for CYANOCOBALAMIN INJECTION
DRUG LABEL	DOSING TYPE	DOSING INSTRUCTIONS
CYANOCOBALAMIN 1,000 MCG/ML VL	Maintenance	Adults inject 1 milliliter (1,000 mcg) by subcutaneous route once a month
CYANOCOBALAMIN 10,000 MCG/10ML	Maintenance	Adults inject 1 milliliter (1,000 mcg) by subcutaneous route once a month
CYANOCOBALAMIN 30,000 MCG/30ML	Maintenance	Adults inject 1 milliliter (1,000 mcg) by subcutaneous route once a month

Generic dosing information for CYANOCOBALAMIN INJECTION
DRUG LABEL	DOSING TYPE	DOSING INSTRUCTIONS
CYANOCOBALAMIN 30,000 MCG/30ML	Maintenance	Adults inject 1 milliliter (1,000 mcg) by subcutaneous route once a month
CYANOCOBALAMIN 10,000 MCG/10ML	Maintenance	Adults inject 1 milliliter (1,000 mcg) by subcutaneous route once a month
CYANOCOBALAMIN 1,000 MCG/ML VL	Maintenance	Adults inject 1 milliliter (1,000 mcg) by subcutaneous route once a month

Contraindication List
Leber's hereditary optic atrophy

Moderate List
Hypokalemia

The following adverse reaction information is available for CYANOCOBALAMIN INJECTION (cyanocobalamin (vitamin b-12)):

Overview
Severe
Less Severe

Adverse reaction overview.

No enhanced Common Adverse Effects information available for this drug.

There are 1 severe adverse reactions.

More Frequent	Less Frequent
None.	None.

Rare/Very Rare
Anaphylaxis

There are 3 less severe adverse reactions.

More Frequent	Less Frequent
None.	Diarrhea Pruritus of skin

Rare/Very Rare
Skin rash

The following precautions are available for CYANOCOBALAMIN INJECTION (cyanocobalamin (vitamin b-12)):

Pediatric
Pregnant
Lactation
Geriatric

No enhanced Pediatric Use information available for this drug.

Contraindicated

None

Severe Precaution

None

Management or Monitoring Precaution

None

Adequate and well-controlled studies have not been conducted in pregnant women. However, vitamin B12 requirements are increased in pregnant women. Parenteral preparations should be used during pregnancy only when the potential benefits justify the potential risks to the fetus.

Vitamin B12 is distributed into human milk. Vitamin B12 requirements are increased in lactating women. Hydroxocobalamin may be administered to lactating women with suspected or known cyanocobalamin poisoning. There is no data available to determine when breastfeeding may be restarted following administration of IV hydroxocobalamin.

No enhanced Geriatric Use information available for this drug.

Pernicious anemia
D51.0	Vitamin b12 deficiency anemia due to intrinsic factor deficiency
Vitamin b12 deficiency
D51	Vitamin b12 deficiency anemia
D51.0	Vitamin b12 deficiency anemia due to intrinsic factor deficiency
D51.1	Vitamin b12 deficiency anemia due to selective vitamin b12 malabsorption with proteinuria
D51.2	Transcobalamin II deficiency
D51.3	Other dietary vitamin b12 deficiency anemia
D51.8	Other vitamin b12 deficiency anemias
D51.9	Vitamin b12 deficiency anemia, unspecified
E53.8	Deficiency of other specified B group vitamins