Hydroxocobalamin (Vitamin B12a)
- Atc Codes:B03BA03#V03AB33
- CAS Codes:13422-51-0
- PHARMGKB ID:13422-51-0
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Genes that may be involved
- Drug Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Cyanokit, Erycytol, Hepavit; Belgium: Cyanokit; Czech Republic: Cyanokit; Denmark: Cyanokit, Vibeden; Estonia: Cyanokit; Finland: Cohemin Depot, Cyanokit; France: Cyanokit, Dodécavit; Germany: B~12~ Depot, Cyanokit, Depogamma, Vitamin B~12~-Depot; Greece: Articlox, Cyanokit; Hungary: Cyanokit; Ireland: Cyanokit; Italy: Cyanokit, Idroxoc, Neocytamen, OH B~12~; Latvia: Cyanokit; Luxembourg: Forta B~12~, Hydroxo 5.000, Novobedouze; Malta: Hydroxocobalamin; Netherlands: Hydrocobamine, Hydroxocobalamine, Cyanokit; Poland: Cyanokit; Portugal: Cyanokit, OHB~12~; Romania: Cyanokit; Slovakia: Cyanokit; Slovenia: Cyanokit; Spain: Cyanokit, Hidroxicobalamina, Megamilbedoce; Sweden: Behepan, Cyanokit; UK: Cobalin-H, Hydroxocobalamin, Neo-Cytamen.
North America
Canada: Acti-B~12~, Hydro Cobex, Hydroxy Cobal; USA: Cyanokit, Hydroxocobalamin.
Latin America
Brazil: Rubranova; Mexico: Axofor, Duradoce, Nebal.
Asia
Japan: Cobalamin-H, Colsamine S, Docelan, Foliron-H, Fresmin-S, Masblon H, V~12~.
Drug combinations
Hydroxocobalamin, Carisoprodol, Dexamethasone, Piroxicam, and Pyridoxine (Vitamin B~6~)
Other Hydroxocobalamin combinations: Betamethasone; Folic Acid (Vitamin B~9~); Iron Dextran; Phosphate; Procaine; Thiamine (Vitamin B~1~)
Chemistry
Hydroxocobalamin: C~62~H~89~CoN~13~O~15~P. Mw: 1346.36 (1) Cobinamide, dihydroxide, dihydrogen phosphate (ester), mono(inner salt), 3′-ester with 5,6-dimethyl-1-α-D-ribofuranosyl-1H-benzimidazole; (2) Cobinamide dihydroxide dihydrogen phosphate (ester), mono(inner salt), 3′-ester with 5,6-dimethyl-1-α-D-ribofuranosylbenzimidazole. CAS-13422-51-0 (1962).
Pharmacologic Category
Vitamins; Vitamin B Complex. Antidotes. Nutritional Supplement. (ATC-Code: B03BA03; V03AB33).
Mechanism of action
Hydroxocobalamin (vitamin B~12a~) is a precursor to cyanocobalamin (vitamin B~12~). Cyanocobalamin acts as coenzyme for various metabolic functions, including fat and carbohydrate metabolism and protein synthesis, used in cell replication and hematopoiesis. In the presence of cyanide, each hydroxocobalamin molecule can bind one cyanide ion by displacing it for the hydroxo ligand linked to the trivalent cobalt ion, forming cyanocobalamin.
Therapeutic use
Treatment of pernicious anemia and other vitamin B~12~ deficiency states. Dietary supplement particularly in conditions of increased requirements (e.g. pregnancy, thyrotoxicosis, hemorrhage, malignancy, liver or kidney disease). Diagnostic agent for Schilling test. Treatment of cyanide poisoning.
Pregnancy and lactiation implications
There are as yet no adequate, well-controlled studies in pregnant women. Use with caution during pregnancy or lactation.
Unlabeled use
Treatment of neuropathies, multiple sclerosis.
Contraindications
Hypersensitivity to hydroxocobalamin, cyanocobalamin, cobalt, or any component of the formulation.
Warnings and precautions
May cause photosensitivity. Vitamin B~12~ deficiency masks signs of polycythemia vera; vitamin B~12~ administration may unmask this condition. Treatment of severe vitamin B~12~ megaloblastic anemia may result in thrombocytosis and severe hypokalemia, sometimes fatal. Use caution in folic acid-deficient megaloblastic anemia. Blunted therapeutic response to vitamin B~12~ may occur in certain conditions (e.g. infection, uremia, concurrent iron or folic acid deficiency) or in patients on medications with bone marrow-suppressant properties (e.g. chloramphenicol). Approved for use as I.M. injection only.