Cyanocobalamin (Vitamin B12)
- Atc Codes:B03BA01
- CAS Codes:68-19-9
- PHARMGKB ID:68-19-9
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Toxicological Effects
- Genes that may be involved
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Vitamin B~12~; Bulgaria: Vitamin B~12~; Czech Republic: Neurobene, Vitamin B~12~; Denmark: Betolvex; Finland: Betolvex; France: Cyanocobalamine, Ecovitamine B~12~, Mono Vitamine B~12~; Germany: Ambe 12, B 12-Asmedic, Basti-B~12~, Cyanocobalamin, Cytobion, Haemo-Vibolex, Lophakomp-B~12~, Novirell B~12~, Röwo Vitamin B~12~, VitaRab; Greece: Cyanocobalamine; Hungary: Cyanokobalamin, Vitamin B~12~; Ireland: Cytamen; Italy: Dobetin; Latvia: Vitamin B~12~; Luxembourg: Ambe 12, Vitamine B~12~; Netherlands: Cyanocobalamine; Poland: IF-12, Vegevit B~12~, Vitaminum B~12~; Portugal: Cianocobalamina B~12~, Permadoze; Romania: Sicovit; Slovakia: Vitamin B~12~; Spain: Isopto B~12~, Cromatonbic B12, Optovite B~12~; Sweden: Betolvex; UK: Cytacon, Cytamen.
North America
USA: CaloMist, Nascobal, Vibisone.
Latin America
Argentina: Reedvit 10000, SL B~12~; Brazil: Bedozil, Cianon B~12~; Mexico: Compensal, Plusvisol.
Asia
Japan: Cobalum, Pharcoba, Sancoba, Softear, Vitacobal, Vitamin B~12~.
Drug combinations
Cyanocobalamin: Acetaminophen, Acorus calamus; Alchemilla vulgaris; Amilase; Amnion bovis fetalis; Anamirta cocculus; Aorta bovis; Ascorbic Acid (Vitamin C); Atropa bella-donna; Aurum chloratum; Aurum metallicum; Avena sativa; Betaine; Betamethasone; Biotin (Vitamin B~7~); Bryonia spp.; Caffeine; Calcium Carbonate; Calcium carbonicum Hahnemanni; Calcium Lactate; Calcium Phosphate; Cimicifuga racemosa; Cinchona pubescens; Cysteine; Citrullus colocynthis; Coenzyme Q~10~; Colon suis; Copper Sulfate; Cor bovis fetalis; Cynara scolymus; Cyproheptadine; Chamaelirium luteum; Chelidonium majus; Cholecalciferol (Vitamin D~3~); Chromium; Dexamethasone, Dexpanthenol; Diclofenac; Diencephalon bovis fetalis; Dipyrone; Duodenum suis; Equisetum arvense; Ergocalciferol (Vitamin D~2~); Fabiana imbricat; Ferrous Fumarate; Ferrous Sulfate; Fluoride; Folic Acid (Vitamin B~9~); Gelsemium sempervirens; Ginkgo biloba; Ginseng; Glandula suprarenalis suis; Glandula thymi bovis fetalis; Glandula thymi suis; Glandula thyreoidea suis; Hawthorn; Hepar bovis; Hepar suis; Hypericum perforatum; Iron; L-Arginine; L-Citrulline; L-Cysteine; L-Glutamine; L-Histidine; Lidocaine; Lien bovis fetalis; L-Isoleucine; L-Leucine; L-Lysine; L-Ornithine; L-Phosphoserine; L-Triptophan; L-Valine; Lycopodium clavatum; Magnesium; Manganese; Melilotus officinalis; Methionine; Molybdenum; Niacin (Vitamin B~3~); Niacinamide; Pancreas bovis; Pancreas suis; Pancrelipase; Pantothenic Acid (Vitamin B~5~); Papain; Phenylalanine; Phosphorus; Phytonadione (Vitamin K); Piritinol; Piroxicam; Pollen; Potassium; Prasterone; Procaine; Pyridoxine (Vitamin B~6~); Ren bovis; Retinol (Vitamin A); Riboflavin (Vitamin B~2~); Rutosidum* sulfuricum natricum; *Selenium; Sepia officinalis; Silybum marianum; Sodium; Solidago virgaurea; Spigelia anthelmia; Strychnos nux-vomica; Symphytum officinale; Taraxacum officinale; Testis bovis; Thiamine (Vitamin B~1~); Threonine; Thuja occidentalis; Tocopherol (Vitamin E); Toxicodendron quercifolium; Tunica mucosa intestini tenuis bovis fetalis; Veratrum album; Vesica fellea suis; Zinc; Zinc Oxide
Chemistry
Cyanocobalamin: C~63~H~88~CoN~14~O~14~P. Mw: 1355.37. Vitamin B~12~. CAS-68-19-9.
Pharmacologic Category
Vitamins; Vitamin B Complex. (ATC-Code: B03BA01).
Mechanism of action
Coenzyme for various metabolic functions, including fat and carbohydrate metabolism and protein synthesis, used in cell replication and hematopoiesis.
Therapeutic use
Pernicious anemia. Vitamin B~12~ deficiency due to dietary deficiencies or malabsorption diseases. Inadequate secretion of intrinsic factor. Inadequate utilization of B~12~. Increased B~12~ requirements due to pregnancy, thyrotoxicosis, hemorrhage, malignancy, liver or kidney disease. Nutritional supplement.
Pregnancy and lactiation implications
Enters breast milk (compatible with lactation). Consider supplementation during breast-feeding in infants of vegetarian mothers (vegetarian diets which contain no animal products do not supply any vitamin B~12~).
Unlabeled use
Contraindications
Hypersensitivity to cyanocobalamin, cobalt, or any component of the formulation.
Warnings and precautions
Vitamin B~12~ deficiency for >3 months results in irreversible degenerative CNS lesions. Spinal cord degeneration might also occur when folic acid is used as a substitute for vitamin B~12~ in anemia prevention. Treatment of severe vitamin B~12~ megaloblastic anemia may result in severe hypokalemia (sometimes fatal, due to intracellular potassium shift upon anemia resolution), and thrombocytosis. Use with caution in Leber’s disease (B~12~ treatment may result in rapid optic atrophy). In pernicious anemia I.M./SubQ routes should be used (oral and intranasal administration not indicated until hematologic remission and no signs of nervous system involvement). Vitamin B~12~ deficiency masks signs of polycythemia vera (vitamin B~12~ administration may unmask this condition). Some parenteral forms contain aluminum (caution in impaired renal function and neonates). Some products contain benzyl alcohol («gasping syndrome» in neonates). Avoid I.V. route (risk of anaphylactic shock). Intradermal test dose of vitamin B~12~ is recommended for any patient suspected of cyanocobalamin sensitivity prior to intranasal or injectable administration. Methotrexate, pyrimethamine, and most antibiotics invalidate folic acid and vitamin B~12~ diagnostic blood assays.