cyanocobalamin

Pronunciation:	sigh ah no ko BALL ah min
Brand:	B-12 Resin, Cobal-1000, Crystal B-12, Crystamine, Crysti-12, Cyanoject, Cyomin, LA-12, Neuroforte-R, Sytobex, Vibal, Vitamin B-12

What is the most important information I should know about cyanocobalamin?

To treat pernicious anemia, you will have to use this medication on a regular basis for the rest of your life. Failure to do this will result in irreversible damage to the nerves of your spinal cord. Also, treatment with cyanocobalamin cannot be substituted with folic acid therapy. Folic acid may prevent anemia but it will allow progressive damage to the spinal cord.

Use the nasal spray one hour before or after eating or drinking hot foods or liquids.

What is cyanocobalamin?

Cyanocobalamin is a synthetic (man-made) form of vitamin B12. Vitamin B12 is important for growth, cell reproduction, blood formation, and protein and tissue synthesis.

Cyanocobalamin is used to treat pernicious anemia, nutritional vitamin B12 deficiency, malabsorption of vitamin B12, and other cases of vitamin B12 deficiency.

Cyanocobalamin may also be used for purposes other than those listed in this medication guide.

Who should not take cyanocobalamin?

Before taking this medication, tell your doctor if you have Leber's disease. Cyanocobalamin may lead to optic nerve damage and possibly blindness when used by people with this condition.

If you are using the nasal spray, tell your doctor if you develop nasal congestion, a cold, or allergies. The nasal spray may not work as well if you are congested.

Cyanocobalamin is in the FDA pregnancy category C. This means that it is not known whether it will harm an unborn baby. Vitamin B12 is important to the proper development of a baby. Talk to your doctor about this medication if you are pregnant.

Cyanocobalamin passes into breast milk. Vitamin B12 is necessary for both mother and child during breast-feeding. Talk to your doctor about taking this medication during breast-feeding.

How should I take cyanocobalamin?

Take cyanocobalamin exactly as directed by your doctor. If you do not understand these directions, ask your doctor, nurse, or pharmacist to explain them to you.

Take the oral tablets with a full glass of water.

Your doctor or nurse will give you specific instructions regarding the injectable form of this medication. It is usually injected into the muscle or just beneath the skin. The injectable form is usually used once a month.

To use the nasal gel:

Gently blow your nose to clear any mucous.
Uncap the pump. Prime the unit (on first use and after 48 hours without use) by pumping it 7 to 8 times until a gel droplet appears at the tip. Then prime the unit with an additional 2 sprays.
Insert the tip about 1 cm into your nostril, pointing it towards the back of the nose.
Block your other nostril and tilt your head forward.
Pump and sniff gently at the same time.
Remove the pump from your nose. Rub your nostril gently for a few seconds.
Clean the pump nozzle with a tissue and recap.

Use only one dose in one nostril unless otherwise directed. The nasal gel is usually used once a week to treat pernicious anemia.

Use the nasal spray one hour before or after eating or drinking hot foods or liquids.

Store this medication at room temperature away from moisture, heat, and light. Keep the nasal gel in the prescription vial when not in use.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the dose you missed and take only your next regularly scheduled dose. Do not use a double dose of this medication unless otherwise directed by your doctor.

What happens if I overdose?

An overdose of cyanocobalamin is unlikely to threaten life. Call your doctor, an emergency room, or a poison control center for advice if you suspect an overdose.

Symptoms of a cyanocobalamin overdose are not known.

What should I avoid while taking cyanocobalamin?

Use the nasal spray one hour before or after eating or drinking hot foods or liquids.

Do not use any other nasal medications while using cyanocobalamin nasal unless they are approved by your doctor.

What are the possible side effects of cyanocobalamin?

If you experience any of the following serious side effects, stop taking cyanocobalamin and seek emergency medical attention:

an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
chest pain or difficulty breathing; or
unusual warmth, redness, or pain in an arm or leg.

Other less serious side effects may be more likely to occur. Continue to take cyanocobalamin and talk to your doctor if you experience

headache;
upset stomach or diarrhea;
numbness or tingling;
fever;
dizziness;
felling of swelling of entire body; or
itching or rash.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect cyanocobalamin?

Do not use any other nasal medications while using cyanocobalamin nasal unless they are approved by your doctor.

Before taking this medication, tell your doctor if you are taking any of the following medications

antibiotics, methotrexate (Rheumatrex), or pyrimethamine (Daraprim). These medicines may interfere with diagnostic tests for vitamin B12 and folic acid.
colchicine, or heavy alcohol use for 2 weeks or longer. These drugs can cause decreased cyanocobalamin absorption.

Drugs other than those listed here may also interact with cyanocobalamin. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

Your pharmacist has additional information about cyanocobalamin written for health professionals that you may read.

What does my medication look like?

Cyanocobalamin is available with a prescription as an injection under the brand names Cyomin and Crystamine in 100 mcg/mL and 1000 mcg/mL strengths. Cyanocobalamin nasal is available with a prescription under the brand name Nascobal in a 500 mcg/spray nasal gel. Cyanocobalamin is also available over-the-counter as a vitamin. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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