Mecobalamin is the neurologically active form of vitamin B12 and occurs as a water-soluble vitamin in the body. It is a cofactor in the enzyme methionine synthase, which functions to transfer methyl groups for the regeneration of methionine from homocysteine. In anaemia, it increases erythrocyte production by promoting nucleic acid synthesis in the bone marrow and by promoting maturation and division of erythrocytes.

Absorption

Peak plasma concentrations after 3 hr (oral); 0.9 hr (IM); 3 min (IV).

Excretion

Via urine.

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Oral: Anorexia, nausea, vomiting and diarrhoea. Parenteral: Rash, headache, hot sensation, diaphoresis and pain/induration at IM inj site. Potentially Fatal: Anaphylactoid reactions (parenteral).

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Decreased GI tract absorption with neomycin, aminosalicylic acid, H2-blockers and colchicine. Reduced serum concentrations with oral contraceptives. Reduced effects in anaemia with parenteral chloramphenicol.

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Oral

Peripheral neuropathies Adult: 1500 mcg/day in 3 divided doses.

Parenteral

Peripheral neuropathies Adult: 500 mcg daily IM/IV 3 times/wk.

Parenteral

Megaloblastic anaemia caused by vitamin B12 deficiency Adult: 500 mcg daily IM/IV 3 times/wk. Maintenance dose: After about 2 mth of therapy, reduce dose to single admin of 500 mcg every 1-3 mth.

May be taken with or without food

Not contraindicated

Not contraindicated

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Oral

Store at room temperature. Protect from moisture and light. Parenteral: Store at room temperature. Do not expose to direct light.

May interfere with precise diagnosis in patients with folate deficiency.