Vitamin B12 Injection

Generic name: Cyanocobalamin

Drug class: Vitamins

Dosage form: Injection

Root of administration: Intramuscular or subcutaneous injection

Dose: The dosage of cyanocobalamin varies based on the specific condition being treated. For example, in the treatment of vitamin B12 deficiency, initial doses may be higher, followed by maintenance doses. The exact dosing regimen should be determined by a healthcare provider.

Mechanism of action: Cyanocobalamin is a synthetic form of vitamin B12, an essential water-soluble vitamin. It plays a crucial role in DNA synthesis, red blood cell formation, and the maintenance of the nervous system. By replenishing vitamin B12 levels, cyanocobalamin helps prevent and treat deficiencies that can lead to anemia and neurological issues.

Drug usage cases:

• Treatment of vitamin B12 deficiency due to malabsorption conditions such as pernicious anemia, gastrointestinal disorders, or after certain surgeries.
• Management of megaloblastic anemia resulting from vitamin B12 deficiency.
• As a diagnostic aid in the Schilling test to assess vitamin B12 absorption.

Drug contraindications:

• Hypersensitivity to cyanocobalamin or any component of the formulation.
• Known allergy to cobalt.

Side effects:

• Injection site reactions such as pain, redness, or swelling.
• Mild diarrhea.
• Headache.
• Nausea.
• Dizziness.
• Fatigue.
• Hypokalemia (low potassium levels) in severe cases.
• Anaphylactic reactions, including shock and death, have been reported.

Warnings:

• Monitor potassium levels during initial treatment, especially in patients with severe megaloblastic anemia, due to the risk of hypokalemia.
• Exercise caution in patients with early Leber’s disease (hereditary optic nerve atrophy), as cyanocobalamin may cause severe optic atrophy.
• An intradermal test dose is recommended before administering cyanocobalamin to patients suspected of being sensitive to this drug.
• Formulations containing benzyl alcohol should be avoided in premature neonates due to the risk of “gasping syndrome.”
• Use with caution in patients with renal impairment, as there is a possibility of greater aluminum accumulation, which may cause central nervous system and bone toxicity.

Use during pregnancy or breastfeeding:

Vitamin B12 is essential during pregnancy and breastfeeding. While adequate and well-controlled studies have not been conducted in pregnant women, vitamin B12 requirements increase during pregnancy. Vitamin B12 is known to be excreted in human milk. The American Academy of Pediatrics considers vitamin B12 to be compatible with breastfeeding. Healthcare providers should consider the benefits of breastfeeding, the risk of potential infant drug exposure, and the risk of untreated or inadequately treated maternal conditions when prescribing vitamin B12 during pregnancy and lactation.