sdz-Vitamin B12 (Cyanocobalamin)

Vitamin B12, or Cyanocobalamin, helps maintain healthy nerve cells and produce DNA. This FDA-approved medication is used to treat B12 deficiency and pernicious anemia. Dosages vary: oral tablets come in 100-1000 mcg, sublingual tablets in 2500 mcg, and injectable solutions in 100 mcg/mL. Recommended doses depend on the condition, with oral dosages typically ranging from 25 to 2000 mcg daily. It’s generally safe, but precautions are necessary for those with Vitamin B12 or cobalt allergies during pregnancy or breastfeeding. Consult a healthcare provider for personalized advice on dosage and administration.

Vitamin B12, also known as Cyanocobalamin, is an essential nutrient crucial for keeping nerve cells healthy by producing DNA and RNA and forming red blood cells. It is commonly used to treat Vitamin B12 deficiency and prevent megaloblastic anemia, which can lead to fatigue and weakness. Additionally, it is utilized to manage pernicious anemia. It is FDA-approved and available in various forms and strengths. Vitamin B12 can be taken orally as tablets (100 mcg, 250 mcg, 500 mcg, 1000 mcg), extended-release tablets (1000 mcg), and sublingual tablets (2500 mcg).

It can also be administered as an injectable solution (100 mcg/mL). The dosage and method of administration depend on the individual’s specific needs and condition. For instance, oral dosages typically range from 25 to 2000 mcg daily, while sublingual tablets may be recommended at 1500 mcg or 2500 mcg daily to prevent B12 deficiency.

While generally safe, Vitamin B12 may cause side effects such as diarrhea, weight loss, shortness of breath, and more severe reactions like difficulty walking, muscle weakness, and memory loss. It is essential to take precautions, especially if you have allergies to cobalt or cobalamin, are pregnant or breastfeeding, or have renal impairment. In case of a missed dose, take it as soon as possible, but avoid doubling up. Store the medication at room temperature, away from light and moisture, and out of reach of children and pets.

• Used in treating Vitamin B12 deficiency
• Pernicious Anemia

Strengths and Forms

• Tablet:
  • 100 mcg
  • 250 mcg
  • 500 mcg
  • 1000 mcg
• Tablet, extended release:
  • 1000 mcg
• Tablet, sublingual:
  • 2500 mcg
• Injectable solution:
  • 100ml

Recommended Dosage for Different Patients

For B12 Nutritional Deficiency:

• Oral Dosage: Typically ranges from 25 to 2000 mcg taken orally daily.
• Sublingual Tablets: To prevent B12 deficiency, a recommended dose of 1500 mcg or 2500 mcg (sublingual tablets) daily.

For Schilling Test:

• The flushing dose is 1000 mcg administered intramuscularly.

For Children with B12 Nutritional Deficiency:

• The usual dose is 0.5 to 3 mcg daily.

[Note: Remember these recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

Here’s a general guide on how to take Vitamin B12 based on the different forms and strengths you’ve listed:

Tablet (100 mcg, 250 mcg, 500 mcg, 1000 mcg): These are regular oral tablets. Typically, you would take one tablet daily with water, with or without food, as directed by your healthcare provider.

Tablet, Extended Release (1000 mcg): This is a slow-release tablet designed to release the vitamin over an extended period. Take one tablet as your healthcare provider prescribes, usually once a day.

Tablet, Sublingual (2500 mcg): This high-dose tablet is meant to be placed under the tongue and allowed to dissolve. Follow your healthcare provider’s instructions, which may vary depending on your specific needs. It’s typically taken once a day or as needed.

Injectable Solution (100 mcg/ml): A healthcare professional usually administers this form. The frequency and dosage depend on the severity of the deficiency and your individual needs. It could range from daily to monthly injections.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

Vitamin B12 is prescribed for maintaining healthy nerve cells and producing DNA and RNA, the body’s genetic material. It works by aiding in the formation of red blood cells and preventing a type of anemia called megaloblastic anemia, which can cause fatigue and weakness. B12 also plays a crucial role in the proper functioning of the brain and nervous system.

Common side effects may include:

• Diarrhea
• Weight loss
• Shortness of breath
• Weakness and fatigue
• Nausea or poor appetite
• Palpitations and rapid heartbeat
• Light-headedness and dizziness
• Yellowish tinge to the skin and eyes
• A sore tongue with a red, beefy appearance

Adverse/Serious side effects may include:

• Dementia
• Memory loss
• Depression
• Difficulty walking
• PsychosisIrritability
• Muscle weakness
• Numbness and tingling in the hands and feet

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

• Do not use Vitamin B12 injections if you have a cobalt allergy or suffer from Leber’s disease.

Health considerations: Consult your doctor or pharmacist before using cyanocobalamin if you have:

• Gout
• Iron or folic acid deficiency anemia
• Polycythemia vera (a type of blood disorder)
• Leber’s optic neuropathy (a certain eye disease)
• Low potassium blood levels (hypokalemia)

Absorption issues: Cyanocobalamin taken orally is only effective if your body can adequately absorb it. If you have pernicious anemia, trouble in absorbing food, or have had stomach/intestinal surgery (like gastric bypass or bowel resection), or if you have conditions like Crohn’s disease, diverticulitis, colitis, or pancreatic insufficiency, or if you’ve had radiation treatment to the small bowel, you may need to get vitamin B12 through injections or nasal spray.

Surgery: Before surgery, informing your doctor or dentist about all your products, including prescription medications, over-the-counter drugs, and herbal supplements, is important.

Pregnancy: Cyanocobalamin is safe to consume when pregnant and taken in recommended doses. Higher doses should be taken only when required after consulting the risks and benefits with your doctor.

• Hypersensitivity to Vitamin B12: Avoid using vitamin B12 if you have a known allergy or hypersensitivity to it or any of its components.
• Hypersensitivity to Cobalt: Since vitamin B12 contains cobalt, consult your healthcare provider before taking it if you have a known allergy to cobalt.
• Neonates (Benzyl Alcohol-Containing Injection Form): The injection form of vitamin B12 containing benzyl alcohol is unsuitable for neonates (newborns) due to the potential toxicity of benzyl alcohol.
• Optic Atrophy (Hereditary): Exercise caution when using vitamin B12 if you have hereditary optic atrophy.
• Renal Impairment (Injection Form): If you have renal impairment and are using vitamin B12 (hydroxocobalamin) injection, close monitoring by a healthcare professional is necessary.

• If you miss a routine dose of Vitamin B12, take it when you remember.
• However, if it’s close to the time for your next dose, skip the missed one and continue with your daily schedule.
• Do not take two doses simultaneously.
• Missing an injection can further decrease vitamin B12 levels in your body, potentially worsening your health issues.
• If you must miss an appointment, consult your doctor or nurse to determine when you should receive your next dose.

[Note: If you have missed a medication dose and are unsure when to take the next one, immediately consult your doctor or pharmacist.]

Taking an additional dose of cyanocobalamin tablets is generally not harmful. However, if you have consumed more than two 1,000 microgram tablets of cyanocobalamin or if you have taken a higher dose than usual and experience nausea, vomiting, diarrhea, or concern, it is important to seek medical advice.

[Note: If you consumed more than the recommended dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]

• Store medication at a temperature between 20° and 25°C (68° to 77°F).
• Keep away from light.
• Store in a cool, dry place at room temperature, but not in the bathroom or freezer.
• Ensure medication is out of reach of children and pets.
• Do not dispose of this medication in the toilet or sink; follow proper disposal methods.
• Use only if the solution is clear and the container is sealed correctly.

[Note: Discuss with your healthcare professional the proper disposal of unused medicine and any questions you may have regarding its storage.]

• Aminosalicylic acid (Paser) treats digestion-related issues, but it might affect your body’s ability to absorb vitamin B12.
• Colchicine (Colcrys, Mitigare, Gloperba) is an anti-inflammatory drug used to prevent and treat gout attacks, and it might affect the absorption of vitamin B12.
• Metformin (Glumetza, Fortamet, and others) is a diabetes drug that might reduce vitamin B12 absorption.
• Proton pump inhibitors, such as omeprazole (Prilosec) and lansoprazole (Prevacid), are the drugs responsible for reducing acid build-up in stomach acid that might decrease the absorption of vitamin B12.
• Taking vitamin C (ascorbic acid) supplements might decrease the levels of vitamin B12 in your body. To prevent this interaction, taking vitamin C at least two hours after consuming a vitamin B12 supplement is advisable.

[Note: This isn’t a complete list, and there could be other drugs that interact with Vitamin B12. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

• Nascobal (cyanocobalamin/nasal)
• Cobolin-M, Depo-Cobolin, Vibal, Cyanoject, Cobal (cyanocobalamin)
• Hydroxocobal, Hydrocobex (hydroxocobalamin)
• Mecobalamin, Methyl-B12, Methylcobal, Mecovon (methylcobalamin)
• Adocbl, Adenosyl-B12, Dibencozide (adenosylcobalamin)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.]

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