Cyanocobalamin information from DrugsUpdate
P - Caution when used during pregnancy
L - Caution when used during lactation
Cyanocobalamin is an especially common vitamer of the vitamin B12 family. It is the most famous vitamer of the family, 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. A form of B12 called hydroxocobalamin is produced by bacteria, and then changed to cyanocobalamin in the process of being purified in activated charcoal columns after being separated from the bacterial cultures. Cyanide is naturally present in activated charcoal, and hydroxocobalamin, which has great affinity for cyanide, picks it up and is changed to cyanocobalamin. Thus, the cyanocobalamin form of B12 is the most widespread in the food industry.
Pharmacodynamics
Pharmacokinetics
Cyanocobalamin is vital to growth, hematopoiesis and nucleoprotein and myelin synthesis. As a hematopoietic agent, it is converted to coenzyme B12 needed in the conversion of methylmalonate to succinate and production of methionine from homocysteine, a reaction requiring folate. In the absence of folate, such metabolites cannot be formed and folate deficiency occurs. It is also involved in the maintenance of reduced sulfhydryl (SH) groups which are required by various SH-activated enzyme systems. Through such processes, cyanocobalamin participates in fat and carbohydrate metabolism as well as protein synthesis.
Absorption
Binds to intrinsic factor secreted by gastric mucosa; via the GI tract actively or by passive diffusion.
Distribution
In the blood, bound to transcobalamin II (specific B-globulin carrier protein); distributed and stored in the liver and bone marrow. Crosses the placenta and small amounts enter the breast milk.
Excretion
Via bile by enterohepatic recycling; via urine (as unbound B12 and in small fraction).
Cyanocobalamin Indications / Cyanocobalamin Uses
Information Not Available
Cyanocobalamin Adverse Reactions / Cyanocobalamin Side Effects
Information Not Available
Precautions
Monitor
Obtain all hematologic parameters, including hemacrit, reticulocyte count, and vitamin B 12 , folate, and iron levels, at the beginning of vitamin B 12 treatment. Monitor serum potassium levels during therapy.
Periodically monitor serum B 12 levels to establish adequacy of therapy. Monitor vitamin B 12 concentrations and CBC 1 month after starting treatment and at 3- to 6-months intervals thereafter. Patients with declining or abnormally low vitamin B 12 concentrations despite maximal doses of intranasal treatment should be switched to IM vitamin B 12 .
Special Precautions
Information Not Available
Other Drug Interactions
Information Not Available
Other Interactions
Information Not Available
Dosage
Intramuscular
Pernicious or macrocytic anaemia
Adult: 250-1000 mcg, given on alternate days for 1-2 weeks, then 250 mcg weekly until the blood count returns to normal. Maintenance doses: 1000 mcg, given every month.
Renal impairment: Increased requirement in renal impairment.
Hepatic impairment: Increased requirement in hepatic impairment.
Food(before/after)
Should be taken on an empty stomach. (Take between meals.)
List of Contraindications
Cyanocobalamin and Pregnancy
Caution when used during pregnancy
Controlled studies in women fail to demonstrate a risk to the foetus in the 1st trimester (and there is no evidence of a risk in later trimesters), and the possibility of foetal harm remains remote.
Cyanocobalamin and Lactation
Caution when used during lactation
Cyanocobalamin and Children
CaloMist
Safety and efficacy not established
Cyanocobalamin and Geriatic
Use with caution, usually starting at the low end of the dosage range, because of the greater frequency of decreased hepatic, renal, or cardiac function, and concomitant diseases or other drug therapy.
Cyanocobalamin and Other Contraindications
Information Not Available
Storage
Information Not Available
Lab interference
Information Not Available
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