Monograph Details
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Hematology
> Anemias
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Cyanocobalamin injection |
| Manufacturer |
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Various generic manufacturers |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Vitamin. |
| Generic Name |
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Cyanocobalamin 1000mcg/mL; soln for IM or SC inj; contains benzyl alcohol. |
| Indications |
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Vitamin B12 deficiencies due to malabsorption. Pernicious anemia. Vitamin B12 absorption test (Schilling test). |
| Children |
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See literature. |
| Adults |
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Give by IM or deep SC inj. Pernicious anemia: 100micrograms daily for 6–7 days; then 100micrograms every other day for 7 doses; then every 3–4 days for 2–3 weeks; then 100micrograms monthly for life. Deficiencies due to malabsorption: if severe, may need to treat like pernicious anemia; use oral preparations for chronic treatment. Schilling test: 1000micrograms. |
| Contraindications |
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Sensitivity to cobalt. |
| Precautions |
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Hereditary optic nerve atrophy (Leber's disease). Severe megaloblastic anemia (intense treatment may lead to hypokalemia and death). Monitor potassium for first 48 hours; replace if needed. Obtain hematocrit, reticulocyte count, Vit. B12, folate, and iron levels before and during treatment. Reevaluate periodically. Premature infants. Renal impairment (possible aluminum toxicity). Folic acid use may mask B12 deficiency. Pregnancy (Cat. C). |
| Interactions |
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Antibiotics, methotrexate, pyrimethamine interfere with vitamin B12 diagnostic tests. Colchicine, para-aminosalicylic acid, heavy alcohol intake for >2 weeks may produce malabsorption of vitamin B12. |
| Adverse Reactions |
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Pulmonary edema, CHF, vascular thrombosis, polycythemia vera, transient diarrhea, itching, transitory exanthema; anaphylactic shock (may be fatal; do test dose if hypersensitivity suspected). |
| How Supplied |
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Contact suppliers. |
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