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Cyanocobalamin is indicated for vitamin B12 deficiencies due to malabsorption which may be associated with the following conditions:
Addisonian (pernicious) anemia
Gastrointestinal pathology, dysfunction, or surgery, including gluten enteropathy or sprue, small bowel bacteria overgrowth, total or partial gastrectomy
Fish tapeworm infestation
Malignancy of pancreas or bowel
Folic acid deficiency
It may be possible to treat the underlying disease by surgical correction of anatomic lesions leading to small bowel bacterial overgrowth, expulsion of fish tapeworm, discontinuation of drugs leading to vitamin malabsorption (see DRUG INTERACTIONS), use of a gluten-free diet in nontropical sprue, or administration of antibiotics in tropical sprue. Such measures remove the need for long-term administration of cyanocobalamin.
Cyanocobalamin Injection, USP is also suitable for the vitamin B12absorption test (Schilling test).
DOSAGE AND ADMINISTRATION
Avoid using the intravenous route. Use of this product intravenously will result in almost all of the vitamin being lost in the urine.
Pernicious Anemia:Parenteral vitamin B12 is the recommended treatment and will be required for the remainder of the patient's life. The oral form is not dependable. A dose of 100 mcg daily for 6 or 7 days should be administered by intramuscular or deep subcutaneous injection. If there is clinical improvement and if a reticulocyte response is observed, the same amount may be given on alternate days for seven doses, then every 3 to 4 days for another 2 to 3 weeks. By this time hematologic values should have become normal. This regimen should be followed by 100 mcg monthly for life. Folic acid should be administered concomitantly if needed.
Patients with Normal Intestinal Absorption: Where the oral route is not deemed adequate, initial treatment similar to that for patients with pernicious anemia may be indicated depending on the severity of the deficiency. Chronic treatment should be with an oral B12 preparation. If other vitamin deficiencies are present, they should be treated.
Schilling Test: The flushing dose is 1000 mcg.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.
Cyanocobalamin Injection, USP 1000 mcg/mL
NDC 0517-0031-25 1 mL Vial Boxes
NDC 0517-0032-25 10 mL Multiple Dose Vial Boxes of 25
NDC 0517-0130-01 30 mL Multiple Dose Vial Individually packaged
NDC 0517-0130-05 30 mL Multiple Dose Vial Boxes of 5
Store at controlled room temperature 15°-30°C (59°-86°F) (See USP).
PROTECT THE PRODUCT FROM LIGHT.
American Regent, Inc.Shirley, NY 11967. FDA Rev date: 9/23/2003
Last reviewed on RxList: 10/23/2008
This monograph has been modified to include the generic and brand name in many instances.
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