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What Is a Vitamin B12 (Cyanocobalamin)?

Vitamin B12, known by its scientific name Cyanocobalamin, is a synthetic version of an essential nutrient our bodies need. This artificial form is used in an injectable format to treat people who don’t have enough of it in their bodies. Vitamin B12 is crucial because it helps our body turn fats and carbohydrates into energy and is vital for creating new proteins. It also plays a significant role in maintaining healthy blood, cells, and nerves. 

If someone doesn’t have enough Vitamin B12, they could face serious health problems, including anemia (a condition where you have fewer red blood cells), stomach troubles, and damage to the nerves.

Vitamin B12 (Cyanocobalamin) Dosage, Usage and Storage


Vitamin B12 (Cyanocobalamin) comes in different strengths and sizes. It’s available in a concentration of 1000 micrograms per milliliter (mcg/mL). You can find it in two sizes of vials:

  • Small vials holding 1 mL each, with 25 vials packed together.
  • Larger vials containing 10 mL each are packaged in two ways: 10 vials or 25 vials per tray.

The correct dosage of cyanocobalamin varies based on your Vitamin B12 levels and the reason they are low. It’s important to follow your doctor’s or pharmacist’s advice regarding the dose you should take.

Generally, the recommended dosages are:

  • The usual dose for a Vitamin B12 deficiency due to diet is between 50 and 150 micrograms, taken once daily.
  • If your B12 deficiency is not diet-related (and you can’t have B12 injections), the typical dose is one or two tablets of vitamin b12 1000mcg (micrograms), taken once or twice daily.
  • For children, the dosages are usually smaller.

How to Take It?

When taking prescribed cyanocobalamin tablets, it’s important to swallow them whole with water without chewing or breaking them. For the best absorption, take these tablets when your stomach is empty. This means you should take them at least 2 hours after eating or snacking and wait at least 30 minutes before your next meal. If you’re using over-the-counter cyanocobalamin supplements, be sure to follow the specific instructions provided in the packet.

How to Store it?

Keep this medication at a temperature between 20° and 25°C (68° to 77°F), and make sure it’s away from light. It’s important to store it in a cool, dry place at room temperature, but not in the bathroom and definitely not in the freezer. Always ensure that the medication is out of reach of children and pets for their safety. Instead of disposing of it in the toilet or sink, please follow the correct disposal methods when it’s expired or no longer needed. Remember to use the medication only if the solution inside is clear and the container is properly sealed.

How Does Cyanocobalamin Work?

Cyanocobalamin is a form of vitamin B12 that helps your body produce red blood cells and maintain a healthy nervous system. If you have a vitamin B12 deficiency, taking cyanocobalamin tablets daily can help. Sometimes, you might need to start with vitamin B12 injections for a quicker increase in your levels. It can take a few weeks for you to notice improvements in symptoms like fatigue. Once your vitamin B12 levels are normal, you might not need to continue taking cyanocobalamin. Regular blood tests are often done to check the vitamin B12 levels in your blood during treatment.


Allergies & Test Dose: Before starting vitamin B12 tablets 1000mcg, inform your doctor if you’re allergic to them or cobalt. You might also react to some non-active parts of this medication. Discuss any allergies with your pharmacist. A smaller initial dose may be suggested to see how you react.

Medical History: Share your medical history with your healthcare provider, focusing on:

  • Low potassium levels (hypokalemia)
  • Gout
  • Kidney problems
  • Polycythemia vera (a blood disorder)
  • Leber’s disease (an eye condition)
  • Deficiencies in other vitamins or minerals, like iron and folic acid.

Pre-Surgical Care: If you’re planning any surgery, inform your doctor or dentist about all the medications you’re taking, including cyanocobalamin, over-the-counter drugs, and herbal supplements.

Pregnancy and Breastfeeding: Use this medication only during pregnancy if necessary. Have a detailed discussion about its risks and benefits with your doctor. Cyanocobalamin may transfer to breast milk, similar to related drugs. Talk to your doctor before breastfeeding while on this medication.

Possible Side Effects of Vitamin B12 (Cyanocobalamin)

Common & Serious Side Effects

  • You might experience pain or redness at the injection site. 
  • You may also feel general discomfort such as itching, mild diarrhea, or a feeling like your body is swelling.
  • Watch out for weakness, muscle cramps, or an irregular heartbeat, which indicate low potassium levels (Hypokalemia). Inform your doctor immediately if these occur.

Rare but Very Serious Side Effects

  • For People with Polycythemia Vera (rare blood disorder), be alert for chest pain, shortness of breath, weakness on one side of the body, sudden vision changes, or trouble speaking.
  • Symptoms like shortness of breath, unusual tiredness, swelling in ankles/feet, or sudden weight gain need immediate medical attention as they can be the symptoms of heart failure.
  • Though rare, look out for a rash, severe dizziness, swelling (especially of the face/tongue/throat), or trouble breathing, as they can be the symptoms of a severe allergic reaction. Get medical help right away if you notice these.

Vitamin B12 (Cyanocobalamin) Interactions

Vitamin B12 (Cyanocobalamin) is generally safe to use with most medications, including common pain relievers. However, it’s important to be aware of how it interacts with certain other drugs, which might affect how well your body absorbs cyanocobalamin. Here are they:

Diabetic medication: If you’re taking metformin for diabetes, it may decrease the amount of cyanocobalamin your body absorbs.

Antacids: Products like Gaviscon, used for heartburn or acid reflux, can also reduce cyanocobalamin absorption.

Heartburn Medications: This includes H2 blockers (such as ranitidine, cimetidine, famotidine, and nizatidine) and proton pump inhibitors (PPIs) like lansoprazole, omeprazole, pantoprazole, or rabeprazole. These medications, used for reducing stomach acid, may impact how much cyanocobalamin your body gets from tablets or food.

Antibiotics: Certain antibiotics, namely chloramphenicol and neomycin, might also affect cyanocobalamin absorption.

Oral Contraceptives: The combined birth control pill could potentially interact with cyanocobalamin.

It’s crucial to inform your doctor or pharmacist if you’re taking any of these medications while on cyanocobalamin. They can help manage any potential interactions. Regarding herbal remedies and supplements, there isn’t much information about their interactions with cyanocobalamin. 

Frequently Asked Questions

What if I forget to take it?

If you miss a cyanocobalamin tablet dose, take it as soon as you remember unless it’s almost time for your next dose. In that case, skip the missed dose and continue your regular schedule. Remember not to take more tablets at once or add extra doses to compensate for the ones you missed. To help remember your medication, consider setting an alarm or ask your pharmacist for other memory aids. This approach ensures you stay on track with your treatment while keeping things safe and simple.

Can Pregnant and breastfeeding women take this medication?

Yes, it is safe to take during pregnancy and breastfeeding. Generally, if you’re eating a balanced diet that includes meat, fish, eggs, milk, and dairy, you don’t need extra B12 supplements unless your doctor recommends them. This vitamin does get into breast milk, but it’s not harmful to your baby. However, if you notice any changes in how your baby feeds or have other concerns, it’s important to immediately speak with your midwife, health visitor, or doctor.

Is there any food or drink I need to avoid?

This medication can be taken with or without food, but it’s more effective if you take it on an empty stomach. This means you should take it either 30 minutes before eating or two hours after a meal. While it’s okay to consume alcohol when using cyanocobalamin, as it doesn’t interfere with the medication’s effectiveness, it’s important to drink responsibly. Excessive and regular alcohol consumption can lead to a deficiency in vitamin B9, also known as folic acid. This deficiency can cause symptoms like fatigue to reappear, as it leads to a type of anemia.

How long does it take to work?

It might take a few weeks for you to notice an improvement in your vitamin B12 levels and symptoms like extreme tiredness or lack of energy. However, if you’re starting your treatment with hydroxocobalamin injections to increase your B12 levels, you might begin to feel better in just a few days when you switch to cyanocobalamin tablets. It’s important to remember that everyone’s body responds differently, so that the exact timing can vary. If you don’t see improvements or if your symptoms persist, consult your healthcare provider for further advice.

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