Generic Name For Vitamin B12

Before Using Cyanocobalamin Injection

• tell your doctor and pharmacist if you are allergic to cyanocobalamin injection, nasal gel, or tablets hydroxocobalamin multi-vitamins any other medications or vitamins or cobalt.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: antibiotics such as chloramphenicol colchicine folic acid methotrexate para-aminosalicylic acid and pyrimethamine . Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you drink or have ever drunk large amounts of alcohol and if you have or have ever had Leber’s hereditary optic neuropathy or kidney disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using cyanocobalamin injection, call your doctor. Talk to your doctor about the amount of vitamin B12 you should get every day when you are pregnant or breast-feeding.

What Is The Dosage For Cyanocobalamin

: Pernicious anemia : 100 mcg intramuscularly or subcutaneously once daily for 6-7 days, followed by the same dose given on alternate days for seven doses, then every 3-4 days for another 2-3 months. Recommended maintenance dose is 100 mcg monthly for life.

For iron deficiency, the recommended dose is 30 mcg intramuscular injection once daily for 5-10 days then 100 to 200 mcg intramuscular injection monthly.

Medications Known To Decrease Vitamin B12 Levels

Summary:

• As summarized in the table provided, vitamin B12 absorptionand utilization by the body can be compromised with the chronic use ofcertain medications which include: colchicine, chloramphenicol, ethanol, histamine 2 receptor antagonists , metformin, and proton pumpinhibitors .
• The chronic use of any of these medications has the potential tocause complications related to vitamin B12 deficiency, which includesimpaired DNA synthesis, impaired cell division, hematopoiesis,hyperhomocysteinemia, and metabolism of odd-chain fatty acids that isnecessary in preventing demyelination of nerves.

Editor-in-Chief:Last Reviewed:

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How Is Cyanocobalamin Injection Given

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Cyanocobalamin injection is injected into a muscle or under the skin. A healthcare provider may teach you how to properly use the medication by yourself.

Your dose needs may change if you become pregnant, if you breastfeed, or if you eat a vegetariandiet. Tell your doctor about any changes in your diet or medical condition.

Always follow directions on the medicine label about giving cyanocobalamin to a child. Your child’s dose will depend on age, weight, diet, and other factors.

For pernicious anemia, you may have to use cyanocobalamin for the rest of your life. Do not stop using the medicine unless your doctor tells you to. Untreated vitamin B12 deficiency can lead to anemia or irreversible nerve damage.

Pernicious anemia is also treated with folic acid to help maintain red blood cells. Folic acid alone will not treat Vitamin B12 deficiency or prevent possible damage to the spinal cord. Use all medications as directed.

You will need frequent medical tests.

This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using cyanocobalamin.

Store this medication at room temperature away from moisture, heat, and light.

Pregnancy Lactation And Early Childhood

The U.S. Recommended Dietary Allowance for pregnancy is 2.6 µg/day, for lactation 2.8 µg/day. Determination of these values was based on the RDA of 2.4 µg/day for non-pregnant women plus what will be transferred to the fetus during pregnancy and what will be delivered in breast milk.:972 However, looking at the same scientific evidence, the European Food Safety Authority sets adequate intake at 4.5 g/day for pregnancy and 5.0 g/day for lactation. Low maternal vitamin B12, defined as serum concentration less than 148 pmol/L, increases the risk of miscarriage, preterm birth and newborn low birth weight. During pregnancy the placenta concentrates B12, so that newborn infants have a higher serum concentration than their mothers. As it is recently absorbed vitamin content that more effectively reaches the placenta, the vitamin consumed by the mother-to-be is more important than that contained in her liver tissue. Women who consume little animal-sourced food, or who are vegetarian or vegan, are at higher risk of becoming vitamin depleted during pregnancy than those who consume more animal products. This depletion can lead to anemia, and also an increased risk that their breastfed infants become vitamin deficient.

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Intramuscular Or Intravenous Injection

Injection of hydroxycobalamin is often used if digestive absorption is impaired, but this course of action may not be necessary with high-dose oral supplements , because with large quantities of the vitamin taken orally, even the 1% to 5% of free crystalline B12 that is absorbed along the entire intestine by passive diffusion may be sufficient to provide a necessary amount.

A person with cobalamin C disease may require treatment with intravenous or intramuscular hydroxocobalamin or transdermal B12, because oral cyanocobalamin is inadequate in the treatment of cobalamin C disease.

Why Is This Medication Prescribed

Cyanocobalamin injection is used to treat and prevent a lack of vitamin B12 that may be caused by any of the following: pernicious anemia certain diseases, infections, or medications that decrease the amount of vitamin B12 absorbed from food or a vegan diet . Lack of vitamin B12 may cause anemia and permanent damage to the nerves. Cyanocobalamin injection also may be given as a test to see how well the body can absorb vitamin B12. Cyanocobalamin injection is in a class of medications called vitamins. Because it is injected straight into the bloodstream, it can be used to supply vitamin B12 to people who cannot absorb this vitamin through the intestine.

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What Is This Medication

Vitamin B12 prevents and treats low vitamin B12 levels in your body. It is used in people who do not get enough vitamin B12 from their diet or when their digestive tract does not absorb enough. Vitamin B12 plays an important role in maintaining the health of your nervous system and red blood cells.

This medicine may be used for other purposes ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME: B-12 Compliance Kit, B-12 Injection Kit, Cyomin, Dodex, LA-12, Nutri-Twelve, Physicians EZ Use B-12, Primabalt

Common Questions About Cyanocobalamin

Cyanocobalamin is a manufactured version of vitamin B12. It works by increasing levels of vitamin B12 in your blood.

You need vitamin B12 to stay healthy. Its used to make red blood cells and keep your nervous system healthy.

Having enough vitamin B12 allows your body to make red blood cells that work properly to carry oxygen around your body.

If you have been diagnosed with low vitamin B12 levels, taking cyanocobalamin helps reduce symptoms such as tiredness and lack of energy or being short of breath.

Vitamin B12 supplements will only improve symptoms such as tiredness and lack of energy if they are caused by low vitamin B12 levels.

It may take a few weeks before your vitamin B12 levels and symptoms start to improve.

If you have hydroxocobalamin injections to boost your vitamin B12 levels at the start of treatment, the cyanocobalamin tablets may start to work within a few days.

Your doctor or pharmacist will advise you how long you need to take cyanocobalamin tablets.

You may be able to stop taking cyanocobalamin when your vitamin B12 blood levels are back to normal.

However, you may need to take it for the rest of your life if your diet does not have enough vitamin B12 or you cannot absorb enough vitamin B12 from your food.

Vitamin B12 supplements containing cyanocobalamin can be bought as tablets , capsules, mouth sprays, and drops.

If you stop taking prescribed cyanocobalamin tablets, your vitamin B12 levels may start to go down.

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Cyanocobalamin 50 Mcg Tablets

This information is intended for use by health professionals

Cytacon 50micrograms Tablets

Each tablet contains 50 micrograms Cyanocobalamin BP.

Excipient with known effect

For the full list of excipients, see section 6.1.

Treatment of nutritional Vitamin B12 deficiency.

Treatment of vitamin B 12 deficiency following partial gastrectomy.

Treatment of tropical sprue, alone or with folic acid.

Treatment of pernicious anaemia when parenteral administration is not possible or not advised.

Posology

The normal dose for adults is appropriate for the elderly.

Adults:

One to three tablets or more daily at the discretion of the physician.

In pernicious anaemia intramuscular therapy is preferable for initial correction of vitamin B12 deficiency. However, if necessary, the oral route may be used to follow this, in which case at least 300 micrograms should be given daily

Paediatric population:

One tablet daily at the discretion of the physician.

When possible, This medicine doses should be taken between meals.

Method of administration: Oral.

Hypersensitivity to the active substance or to any of the excipients listed in section 6.1.

Hypersensitivity to the product or any of the excipients.

For pernicious anaemia, an adequate dose must be used and the blood picture must be examined regularly at least every three months for 18 months until stabilised, and then annually.

Indiscriminate administration of this medicine may mask precise diagnosis.

Pregnancy

None.

ATC code: B03BA01

Some Side Effects Can Be Serious The Following Symptoms Are Uncommon But If You Experience Any Of Them Call Your Doctor Immediately:

• muscle weakness, cramps, or pain
• shortness of breath, especially when you exercise or lie down
• coughing or wheezing
• swelling of the arms, hands, feet, ankles or lower legs
• pain, warmth, redness, swelling or tenderness in one leg
• red skin color, especially on the face
• difficulty breathing or swallowing

Cyanocobalamin injection may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s MedWatch Adverse Event Reporting program online or by phone .

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Who Can And Cannot Take Cyanocobalamin

Most adults and children aged 2 years and over can take cyanocobalamin.

Its not suitable for everyone. To make sure its safe for you, tell your doctor before starting cyanocobalamin if you:

• have ever had an allergic reaction to cyanocobalamin or any other medicine
• have an allergy to cobalt

Some cyanocobalamin tablets may not be suitable for people on a vegan diet.

What Is The Most Important Information I Should Know About Methylcobalamin

You should not use methylcobalamin if you are allergic to vitamin B12 or cobalt.

Tell your doctor if you have ever had:

• Leber’s disease or other form of optic nerve damage
• an iron or folic acid deficiency or
• low levels of potassium in your blood.

Tell your doctor if you are pregnant or breastfeeding.

Do not give this medicine to a child without medical advice.

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What Are Dosages Of Cyanocobalamin

Dosages of Cyanocobalamin:

Dosage Considerations Should be Given as Follows:

Nutritional Supplementation

• Adults over 19 years: 2.4 mcg
• Pregnant women: 2.6 mcg

• Infants 0-6 months: 0.4 mcg
• Infants 7-12 months: 0.5 mcg
• Children 1-3 years: 0.9 mcg
• Children 4-8 years: 1.2 mcg
• Children 9-13 years: 1.8 mcg
• Children over 14 years: 2.4 mcg

Pernicious Anemia

Adult Dosages

• Manufacturer recommendation: 100 mcg intramuscularly or subcutaneously once daily for 6-7 days, then every other day for 7 doses, then 3-4 days for 2-3 weeks, then monthly
• Alternative parenteral dosing: 1,000 mcg intramuscularly or subcutaneously once daily for 7 days, then weekly for 1 month, then monthly
• Nasal spray: 500 mcg weekly if the patient is taking hot meals, the spray should be administered 1 hour before or after a meal

Pediatric Dosages

• 30-50 mcg intramuscularly or subcutaneously once daily for 2 weeks or more for a total dose of 1,000 mcg to 5,000 mcg administer concomitantly with 1 mg/day of folic acid for 1 month
• Maintenance: 100 mcg intramuscularly or subcutaneously monthly

B12 Deficiency

• Initial: 30 mcg intramuscularly once daily for 5-10 days
• Maintenance: 100-200 mcg intramuscularly monthly
• Nasal dose: 500 mcg once weekly

Dosing considerations:

• Cyanidepoisoning: see hydroxycobalamin AD

Pediatric Dosages

• 0.2 mcg/kg for 2 days follow by 1,000 mcg/day for 2-7 days follow by 100 mcg/day for 2-7 days then 100 mcg/week for 1 month

• low blood levels of potassium
• irregular heartbeat

How Should I Use This Medication

This medication is injected into a muscle or deeply under the skin. It is usually given in a clinic or care team’s office. However, your care team may teach you how to inject yourself. Follow all instructions.

Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

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What If I Forget To Take It

If you forget to take cyanocobalamin tablets, take your usual dose as soon as you remember, unless its nearly time for your next dose. 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.

Before Taking This Medicine

You should not use Vitamin B12 if you are allergic to cyanocobalamin or cobalt, or if you have Leber’s disease . Cyanocobalamin can lead to optic nerve damage in people with Leber’s disease.

To make sure this medicine is safe for you, tell your doctor if you have:

• eye problems or Leber’s disease

• iron or folic acid deficiency

• any type of infection or

• if you are receiving any medication or treatment that affects bone marrow.

Tell your doctor if you are pregnant or breastfeeding. Your dose needs may be different during pregnancy or while you are nursing.

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How Is Vitamin B12 Injection Given

Use Vitamin B12 exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets.

Vitamin B12 injection is injected into a muscle or under the skin. A healthcare provider may teach you how to properly use the medication by yourself.

Your dose needs may change if you become pregnant, if you breastfeed, or if you eat a vegetarian diet. Tell your doctor about any changes in your diet or medical condition.

Always follow directions on the medicine label about giving Vitamin B12 injection to a child. Your child’s dose will depend on age, weight, diet, and other factors.

For pernicious anemia, you may have to use Vitamin B12 injection for the rest of your life. Do not stop using the medicine unless your doctor tells you to. Untreated vitamin B12 deficiency can lead to anemia or irreversible nerve damage.

Pernicious anemia is also treated with folic acid to help maintain red blood cells. Folic acid alone will not treat Vitamin B12 deficiency or prevent possible damage to the spinal cord. Use all medications as directed.

You will need frequent medical tests.

Vitamin B12 can affect the results of certain medical tests. Tell any doctor who treats you that you are using Vitamin B12 injection.

Store this medication at room temperature away from moisture, heat, and light.

Gene And Protein Expression

About 20,000 protein coding genes are expressed in human cells and 60% of these genes are expressed in a normal, adult liver. Over 400 genes are more specifically expressed in the liver, with some 150 genes highly specific for liver tissue. A large fraction of the corresponding liver-specific proteins are mainly expressed in hepatocytes and secreted into the blood and constitute plasma proteins and . Other liver-specific proteins are certain such as and , proteins involved in bile synthesis such as and , and transporter proteins involved in the metabolism of drugs, such as and . Examples of highly liver-specific proteins include , coagulation factors and , , and the protein.

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Identification Of The Active Compound

While working at the Bureau of Dairy Industry, U.S. Department of Agriculture, was assigned work on the bacterial strain Lactobacillus lactis Dorner , which was used to make yogurt and other cultured dairy products. The culture medium for LLD required liver extract. Shorb knew that the same liver extract was used to treat pernicious anemia , and concluded that LLD could be developed as an assay method to identify the active compound. While at the University of Maryland she received a small grant from Merck, and in collaboration with Karl Folkers from that company, developed the LLD assay. This identified “LLD factor” as essential for the bacteria’s growth. Shorb, Folker and Alexander R. Todd, at the University of Cambridge, used the LLD assay to extract the anti-pernicious anemia factor from liver extracts, purify it, and name it vitamin B12. In 1955, Todd helped elucidate the structure of the vitamin, for which he was awarded the Nobel Prize in Chemistry in 1957. The complete chemical structure of the molecule was determined by Dorothy Hodgkin, based on crystallographic data in 1956, for which for that and other crystallographic analyses she was awarded the Nobel Prize in Chemistry in 1964. Hodgkin went on to decipher the structure of insulin.

Five people have been awarded Nobel Prizes for direct and indirect studies of vitamin B12: George Whipple, George Minot and William Murphy , Alexander R. Todd , and Dorothy Hodgkin .