Cyanocobalamin

Cyanocobalamin is also called vitamin B12. It is the most recently discovered of the vitamin B series, was isolated from the liver fraction in 1948. Cyanocobalamin is a complex water soluble compound. It is made up of a porphyrin like ring with a central cobalt atom attached to a nucleotide. It is required in body for growth, cell production and for blood and nerve function. The source of vitamin B12 is microbial synthesis, it is not present in plants or cereal grains to a measurable extent. The chief dietary source is microbial derived vitamin B12 in meat, eggs and dairy products. Humans must obtain the vitamin from the dietary intake of animal products.

Cyanocobalamin is primarily indicated in conditions like Addisonian pernicious anemia, Congenital cobalamin malabsorption, Congenital intrinsic factor deficiency, Homocystenemia, Ileal resection, Methylmalonylacidurias, Nutrition deficiency, Post gastrectomy Vit B-12 deficiency, Transcobalamin II deficiency, and can also be given in adjunctive therapy as an alternative drug of choice in Infestations, Malignancy, Tapeworm infection, Vitamin-B12 deficiency of dietary origin.

Cyanocobalamin is contraindicated in conditions like Anaphylactic reactions, Tobacco amblyopia, Hypersensitivity to product/Cobalt

Generalized : Anaphylactic shock and death have been reported with administration of parenteral vitamin B 12 (see WARNINGS ). Cardiovascular : Pulmonary edema and congestive heart failure early in treatment; peripheral vascular thrombosis. Hematological : Polycythemia vera Gastrointestinal : Mild transient diarrhea Dermatological : Itching; transitory exanthema Miscellaneous : Feeling of swelling of entire body

Patients with early Leber's disease (hereditary optic nerve atrophy) who were treated with cyanocobalamin suffered severe and swift optic atrophy. Hypokalemia and sudden death may occur in severe megaloblastic anemia which is treated intensely. Anaphylactic shock and death have been reported after parenteral vitamin B 12 administration. An intradermal test dose is recommended before Cyanocobalamin Injection, USP is administered to patients suspected of being sensitive to this drug. This product contains Benzyl Alcohol. Benzyl Alcohol has been reported to be associated with a fatal "Gasping Syndrome" in premature infants. This product contains aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which contain aluminum. Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 mcg/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity. Tissue loading may occur at even lower rates of administration.

Patients with early Leber's disease (hereditary optic nerve atrophy) who were treated with cyanocobalamin suffered severe and swift optic atrophy. Hypokalemia and sudden death may occur in severe megaloblastic anemia which is treated intensely. Anaphylactic shock and death have been reported after parenteral vitamin B 12 administration. An intradermal test dose is recommended before Cyanocobalamin Injection, USP is administered to patients suspected of being sensitive to this drug. This product contains Benzyl Alcohol. Benzyl Alcohol has been reported to be associated with a fatal "Gasping Syndrome" in premature infants. This product contains aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which contain aluminum. Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 mcg/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity. Tissue loading may occur at even lower rates of administration.

100 mcg (100 (100)) 24 hourly IM, Deep SC — For 6-7 days. If response observed then same days on alternate days for 7 doses, then every 3-4 days for another 2-3 weeks, then monthly for life in Pernicious Anemia 250 to 1000 mcg (620 (625)) As recommended. IM — Every alternate day for 1-2 weeks, Maintenance dose is given monthly. Scraped Dose — No overdosage has been reported with this drug.

10 ug/kg (10 (10)) As recommended. Subcutaneous — Maintenance, once in a month 3 to 5 ug /kg (4 (4)) 24 hourly Intra Muscular — Initially for 2 or more weeks 3 to 5 ug/kg (4 (4)) 24 hourly Subcutaneous — Initially for 2 or more weeks

10 ug/kg (10 (10)) As recommended. Intra Muscular — Maintenance, once in a month 10 ug/kg (10 (10)) As recommended. Subcutaneous — Maintenance, once in a month 3 to 5 ug /kg (4 (4)) 24 hourly Intra Muscular — Initially for 2 or more weeks 3 to 5 ug/kg (4 (4)) 24 hourly Subcutaneous — Initially for 2 or more weeks

Persons taking most antibiotics, methotrexate and pyrimethamine invalidate folic acid and vitamin B 12 diagnostic blood assays. Colchicine para-aminosalicylic acid and heavy alcohol intake for longer than 2 weeks may produce malabsorption of vitamin B 12 .

Inj, Tab, Caps, Nasal Gel Store in a well closed container, at room temperature, Between 15°C-30°C. Protect from Sunlight, Moisture and Heat.