Indications for Cyanocobalamin injection:
Vit. B12 deficiencies due to malabsorption. Pernicious anemia. Vit. B12 absorption test (Schilling test).
Give by IM or deep SC inj. Pernicious anemia: 100mcg daily for 6–7 days; then 100mcg every other day for 7 doses; then every 3–4 days for 2–3 weeks; then 100mcg monthly for life. Deficiencies due to malabsorption: if severe, may need to treat like pernicious anemia; use oral preparations for chronic treatment. Schilling test: 1000mcg.
Sensitivity to cobalt.
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).
Antibiotics, methotrexate, pyrimethamine interfere with Vit. B12 diagnostic tests. Colchicine, para-aminosalicylic acid, heavy alcohol intake for >2 weeks may produce malabsorption of Vit. B12.
Pulmonary edema, CHF, vascular thrombosis, polycythemia vera, transient diarrhea, itching, transitory exanthema; anaphylactic shock (may be fatal; do test dose if hypersensitivity suspected).
Formerly known under the brand names Berubigen, Cobavite, Rubivite, Rubramin PC, Vi-twel.