Monograph Details
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Hematology
> Anemias
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CALOMIST |
| Manufacturer |
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Fleming & Company |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Hematinic. |
| Generic Name |
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Cyanocobalamin 25micrograms/spray; nasal spray. |
| Indications |
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Maintenance of Vit. B12 concentrations after normalization with IM Vit. B12 therapy in patients with Vit. B12 deficiency who have no nervous system involvement. |
| Children |
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Not recommended. |
| Adults |
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Not for newly diagnosed Vit. B12 deficiency. Initially 1 spray in each nostril daily (50micrograms/day); if response inadequate, may increase to twice daily dosing (100micrograms/day). Renal or hepatic impairment: may require increased dosing or frequency. |
| Precautions |
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Avoid in Leber's disease. Vit. B12 concentrations should be normal prior to treatment; switch to IM injections if levels are low or decline. Nasal pathology; defer until nasal symptoms subside. Infections, uremia, concurrent iron, folic acid deficiency; may blunt therapeutic response. Obtain hematocrit, reticulocyte count, Vit. B12, folate, and iron levels prior to and during treatment. Monitor potassium and platelet count during intense megaloblastic anemia treatment. Pregnancy (Cat.C). Nursing mothers. |
| Interactions |
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Iron supplements or bone marrow suppressants (eg, chloramphenicol) may blunt therapeutic response. Antibiotics, methotrexate, pyrimethamine may interfere with lab tests. Do not use for Schilling Test. |
| Adverse Reactions |
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Rhinorrhea, nasopharyngitis, arthralgia, dizziness, headache, nasal discomfort, pain, bronchitis, rash. |
| How Supplied |
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Nasal spray—30mL (60 sprays) |
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