Crystamine

Cyanocobalamin is a prescription medication used to used to treat and prevent a lack of vitamin B₁₂.

Cyanocobalamin belongs to a group of drugs called vitamins. These help to supply vitamin B₁₂.

This medication is available in an injectable form to be given directly into the muscle (IM) or under the skin by a healthcare professional.

Common side effects of cyanocobalamin include diarrhea and feeling as if your entire body is swollen.

Cyanocobalamin is a prescription medication used to treat and prevent a lack of vitamin B₁₂ that may be caused by any of the following:

• pernicious anemia (lack of a natural substance needed to absorb vitamin B₁₂ from the intestine)
• folic acid deficiency
• certain diseases
• infections
• malignancy of pancreas or bowel
• medications that decrease the amount of vitamin B₁₂ absorbed from food
• a vegan diet (strict vegetarian diet that does not allow any animal products, including dairy products and eggs)

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with cyanocobalamin. See the “Cyanocobalamin Precautions” section.

Common side effects of cyanocobalamin include the following:

• diarrhea
• feeling as if your entire body is swollen
• itching
• eruption of the skin
• diarrhea

This is not a complete list of cyanocobalamin side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• antibiotics such as chloramphenicol (Chloromycetin, Mychel-S)
• colchicine (Colcrys)
• folic acid
• methotrexate (Rheumatrex, Trexall)
• para-aminosalicylic acid (Paser)
• pyrimethamine (Daraprim)

Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

This is not a complete list of cyanocobalamin drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with cyanocobalamin including the following:

• Hypokalemia and sudden death may occur in severe megaloblastic anemia.
• Anaphylactic shock and death. Anaphylactic shock and death have been reported after cyanocobalamin administration.
• "Gasping Syndrome" in premature infants. This product contains Benzyl Alcohol. Benzyl Alcohol has been reported to be associated with a fatal "Gasping Syndrome" in premature infants.
• Aluminum toxicity. This product contains aluminum that may be toxic. Aluminum may reach toxic levels with prolonged administration in patients with impaired kidney function.
• Congestive heart failure. Tell your healthcare provider right away if you experience any of the following symptoms of CHF:
  • sudden weight gain
  • worsening shortness of breath
  • increased swelling of your feet, legs, or abdomen
  • needing to use more pillows to go to sleep or sleeping in a recliner
  • waking from sleep to catch your breath
  • a cough that does not go away
  • new or increasing irregularities in your heart rate
• Production of too many red blood cells.

Do not take cyanocobalamin if you:

• are allergic to cyanocobalamin or to any of its ingredients
• have sensitivity to cobalt

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of cyanocobalamin, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking cyanocobalamin, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to cyanocobalamin or to any of its ingredients
• are allergic to hydroxocobalamin; multi-vitamins; any other medications or vitamins; or cobalt.
• drink or have ever drunk large amounts of alcohol
• have or have ever had Leber's hereditary optic neuropathy (slow, painless loss of vision, first in one eye and then in the other)
• have kidney disease
• are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using cyanocobalamin injection, call your doctor. Talk to your doctor about the amount of vitamin B₁₂ you should get every day when you are pregnant or breast-feeding.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Cyanocobalamin falls into category C.There are no well-controlled studies that have been done in pregnant women. Cyanocobalamin should be used during pregnancy only if the possible benefit outweighs the possible risk to the unborn baby.

However, vitamin B12 is an essential vitamin and requirements are increased during pregnancy. Amounts of vitamin B12 that are recommended by the Food and Nutrition Board, National Academy of Science-National Research Council for pregnant women (4 mcg daily) should be consumed during pregnancy.

Tell your doctor if you are breastfeeding or plan to breastfeed.

Cyanocobalamin has been detected in human breast milk.

Amounts of vitamin B12 that are recommended by the Food and Nutrition Board, National Academy of Science-National Research Council for lactating women (4 mcg daily) should be consumed during lactation.

Take Cyanocobalamin exactly as prescribed.

This medication is available in an injectable form to be given directly into the muscle (IM) or under the skin by a healthcare professional.

Patients with pernicious anemia will require monthly injections of vitamin B12 for the remainder of their lives.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of cyanocobalamin at the same time.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication

The recommended dose of cyanocobalamin for the treatment of pernicious anemia is 100 mcg a day. A dose of 100 mcg daily for 6 or 7 days should be administered. If there is clinical improvement the same amount may be given on alternate days for seven doses, then every 3 to 4 days for another 2 to 3 weeks. The regimen will depend on you respond to cyanocobalamin.

This regimen should be followed by 100 mcg monthly for life.

If cyanocobalamin is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to cyanocobalamin injection.

Unless your doctor tells you otherwise, continue your normal diet.