No

Vitamin, Water Soluble

Treatment of pernicious anemia, vitamin B₁₂ deficiency, increased B₁₂ requirements due to pregnancy, thyrotoxicosis, hemorrhage, malignancy, liver or kidney disease

A/C (if doses exceed RDA recommendation)

Hypersensitivity to cyanocobalamin or any component, cobalt; patients with hereditary optic nerve atrophy

Some products contain benzoyl alcohol; avoid use in premature infants; an intradermal test dose should be performed for hypersensitivity; use only if oral supplementation not possible or when treating pernicious anemia

1% to 10%:

Dermatologic: Itching

Gastrointestinal: Diarrhea

<1%: Peripheral vascular thrombosis, urticaria, anaphylaxis

No data reported

Clear pink to red solutions are stable at room temperature; protect from light; incompatible with chlorpromazine, phytonadione, prochlorperazine, warfarin, ascorbic acid, dextrose, heavy metals, oxidizing or reducing agents; avoid freezing

Coenzyme for various metabolic functions, including fat and carbohydrate metabolism and protein synthesis, used in cell replication and hematopoiesis

Vitamin B₁₂ deficiency: I.M.:

Adults: 30 mcg/day for 5-10 days, followed by 100-200 mcg/month

Administer I.M. only; may require coadministration of folic acid

None noted

None noted

No information available to require special precautions

No effects or complications reported

Use exactly as directed. Pernicious anemia may require monthly injections for life. Report skin rash; swelling, pain, or redness in extremities; or acute persistent diarrhea.

Therapy is required throughout life; do not administer folic acid instead of B₁₂ to prevent anemia

Injection: 1000 mcg/mL (10 mL, 30 mL)

Cottrell JE, Casthely P, Brodie JD, et al, "Prevention of Nitroprusside-Induced Cyanide Toxicity With Hydroxocobalamin," N Engl J Med, 1978, 298(15):809-11.

Curry SC, Connor DA, and Raschke RA, "Effect of the Cyanide Antidote Hydroxocobalamin on Commonly Ordered Serum Chemistry Studies," Ann Emerg Med, 1994, 24(1):65-7.

Holland MA and Kozlowski LM, "Clinical Features and Management of Cyanide Poisoning," Clin Pharm, 1986, 5(9):737-41.

Lindenbaum J, Healton EB, Savage DG, et al, "Neuropsychiatric Disorders Caused by Cobalamin Deficiency in the Absence of Anemia or Macrocytosis," N Engl J Med, 1988, 318(26):1720-8.

Olszewski AJ, Szostak WB, Bialkowska M, et al, "Reduction of Plasma Lipid and Homocysteine Levels by Pyridoxine, Folate, Cobalamin, Choline, Riboflavin, and Troxerutin in Atherosclerosis," Atherosclerosis, 1989, 75(1):1-6.

Regland B, Gottfries CG, and Lindstedt G, "Dementia Patients With Low Serum Cobalamin Concentration: Relationship to Atrophic Gastritis," Aging Milano, 1992, 4(1):35-41.