Cyanocobalamin

Cyanocobalamin
Adult Indications & Dosage
Pediatric Indications & Dosage
Contraindications
Warnings & Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Administration & Monitoring
Overdosage
Pharmacology
Clinical Studies
How Supplied
Images
Patient Counseling Information
Precautions with Alcohol
Brand Names
Look-Alike Names

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Gloria Picoy [2]

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Overview

Cyanocobalamin is a vitamin B combination that is FDA approved for the treatment of cobalamin deficiency, malabsorption of cyanocobalamin and pernicious anemia; prophylaxis cobalamin deficiency; and diagnosis with Schilling test. Common adverse reactions include injection site pain, arthralgia, dizziness, headache and nasopharyngitis..

Adult Indications and Dosage

FDA-Labeled Indications and Dosage (Adult)

Cyanocobalamin is indicated for vitamin B12 deficiencies due to malabsorption which may be associated with the following conditions:

• Addisonian (pernicious) anemia
• Gastrointestinal pathology, dysfunction, or surgery, including gluten enteropathy or sprue, small bowel bacteria overgrowth, total or partial gastrectomy
• Fish tapeworm infestation

Malignancy of pancreas or bowel
Folic acid deficiency

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 B12 in excess of normal (due to pregnancy, thyrotoxicosis, hemolytic anemia, hemorrhage, malignancy, hepatic and renal disease) can usually be met with oral supplementation.

Cyanocobalamin Injection, USP is also suitable for the vitamin B12 absorption test

Off-Label Use and Dosage (Adult)

Guideline-Supported Use

There is limited information regarding Off-Label Guideline-Supported Use of Cyanocobalamin in adult patients.

Non–Guideline-Supported Use

There is limited information regarding Off-Label Non–Guideline-Supported Use of Cyanocobalamin in adult patients.

Pediatric Indications and Dosage

FDA-Labeled Indications and Dosage (Pediatric)

There is limited information regarding Cyanocobalamin FDA-Labeled Indications and Dosage (Pediatric) in the drug label.

Off-Label Use and Dosage (Pediatric)

Guideline-Supported Use

There is limited information regarding Off-Label Guideline-Supported Use of Cyanocobalamin in pediatric patients.

Non–Guideline-Supported Use

There is limited information regarding Off-Label Non–Guideline-Supported Use of Cyanocobalamin in pediatric patients.

Contraindications

There is limited information regarding Cyanocobalamin Contraindications in the drug label.

Warnings

There is limited information regarding Cyanocobalamin Warnings' in the drug label.

Adverse Reactions

Clinical Trials Experience

There is limited information regarding Cyanocobalamin Clinical Trials Experience in the drug label.

Postmarketing Experience

There is limited information regarding Cyanocobalamin Postmarketing Experience in the drug label.

Drug Interactions

There is limited information regarding Cyanocobalamin Drug Interactions in the drug label.

Use in Specific Populations

Pregnancy

Pregnancy Category (FDA): There is no FDA guidance on usage of Cyanocobalamin in women who are pregnant.
Pregnancy Category (AUS): There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Cyanocobalamin in women who are pregnant.

Labor and Delivery

There is no FDA guidance on use of Cyanocobalamin during labor and delivery.

Nursing Mothers

There is no FDA guidance on the use of Cyanocobalamin in women who are nursing.

Pediatric Use

There is no FDA guidance on the use of Cyanocobalamin in pediatric settings.

Geriatic Use

There is no FDA guidance on the use of Cyanocobalamin in geriatric settings.

Gender

There is no FDA guidance on the use of Cyanocobalamin with respect to specific gender populations.

Race

There is no FDA guidance on the use of Cyanocobalamin with respect to specific racial populations.

Renal Impairment

There is no FDA guidance on the use of Cyanocobalamin in patients with renal impairment.

Hepatic Impairment

There is no FDA guidance on the use of Cyanocobalamin in patients with hepatic impairment.

Females of Reproductive Potential and Males

There is no FDA guidance on the use of Cyanocobalamin in women of reproductive potentials and males.

Immunocompromised Patients

There is no FDA guidance one the use of Cyanocobalamin in patients who are immunocompromised.

Administration and Monitoring

Administration

There is limited information regarding Cyanocobalamin Administration in the drug label.

Monitoring

There is limited information regarding Cyanocobalamin Monitoring in the drug label.

IV Compatibility

There is limited information regarding the compatibility of Cyanocobalamin and IV administrations.

Overdosage

There is limited information regarding Cyanocobalamin overdosage. If you suspect drug poisoning or overdose, please contact the National Poison Help hotline (1-800-222-1222) immediately.

Pharmacology

There is limited information regarding Cyanocobalamin Pharmacology in the drug label.

Mechanism of Action

There is limited information regarding Cyanocobalamin Mechanism of Action in the drug label.

Structure

There is limited information regarding Cyanocobalamin Structure in the drug label.

Pharmacodynamics

There is limited information regarding Cyanocobalamin Pharmacodynamics in the drug label.

Pharmacokinetics

There is limited information regarding Cyanocobalamin Pharmacokinetics in the drug label.

Nonclinical Toxicology

There is limited information regarding Cyanocobalamin Nonclinical Toxicology in the drug label.

Clinical Studies

There is limited information regarding Cyanocobalamin Clinical Studies in the drug label.

How Supplied

There is limited information regarding Cyanocobalamin How Supplied in the drug label.

Storage

There is limited information regarding Cyanocobalamin Storage in the drug label.

Images

Drug Images

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Package and Label Display Panel

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Patient Counseling Information

There is limited information regarding Cyanocobalamin Patient Counseling Information in the drug label.

Precautions with Alcohol

Alcohol-Cyanocobalamin interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.

Brand Names

There is limited information regarding Cyanocobalamin Brand Names in the drug label.

Look-Alike Drug Names

There is limited information regarding Cyanocobalamin Look-Alike Drug Names in the drug label.

Drug Shortage Status

Price

References

The contents of this FDA label are provided by the National Library of Medicine.

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List of terms related to Cyanocobalamin

Cyanocobalamin is an especially common "vitamer" (that is, member of a family of vitamins, all of which have some particular nutritional activity in preventing some vitamin deficiency disease). In the case of the B-12 vitamin family (see Vitamin B-12), cyanocobalamin is the most famous of the B-12 vitamers, because it is chemically the most air-stable, and it is the easiest to crystallize and therefore easiest to purify after it is produced by bacterial fermentation. The cyanide is added to the molecule by activated charcoal columns in purification. Thus, the use of this form of B-12 is the most wide-spread.

This latter fact has caused some people (usually from reading labels on packages and vitamin supplements, in which vitamin B-12 is almost always listed last, since ingredients by law are listed in order of weight %), to infer that the "correct" chemical name of vitamin B-12 actually IS cyanocobalamin. In fact, "vitamin B-12" is the name for a whole class of chemicals with B-12 activity, and "cyanocobalamin" is only one of these. Cyanocobalamin usually does not even occur in nature, and cyanocobalamin is not one of the forms of this vitamin which is directly used in the human body (or that of any other animal). However, animals and humans can convert it to active (cofactor) forms of the vitamin, such as methylcobalamin.