Brand Names: CaloMist, Nascobal

Generic Name: cyanocobalamin (nasal) (Pronunciation: sye AN oh koe BAL a min)

• What is nasal cyanocobalamin (Nascobal)?
• What are the possible side effects of nasal cyanocobalamin (Nascobal)?
• What is the most important information I should know about nasal cyanocobalamin (Nascobal)?
• What should I discuss with my healthcare provider before using nasal cyanocobalamin (Nascobal)?
• How should I use nasal cyanocobalamin (Nascobal)?
• What happens if I miss a dose (Nascobal)?
• What happens if I overdose (Nascobal)?
• What should I avoid while using nasal cyanocobalamin (Nascobal)?
• What other drugs will affect nasal cyanocobalamin (Nascobal)?
• Where can I get more information?

What is nasal cyanocobalamin (Nascobal)?

Cyanocobalamin is a man-made form of vitamin B12. Vitamin B12 is important for growth, cell reproduction, blood formation, and protein and tissue synthesis.

Cyanocobalamin is used to treat vitamin B12 deficiency in people with pernicious anemia and other conditions.

Cyanocobalamin may also be used for other purposes not listed in this medication guide.

What are the possible side effects of nasal cyanocobalamin (Nascobal)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

• chest pain;
• feeling short of breath, even with mild exertion;
• swelling, rapid weight gain; or
• unusual warmth, redness, or pain in an arm or leg.

Less serious side effects may include:

• headache, dizziness, weakness;
• nausea, upset stomach, diarrhea;
• numbness or tingling;
• runny nose, sneezing, sore throat, swollen tongue;
• fever;
• joint pain; or
• itching or rash.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Read the Nascobal (cyanocobalamin) Side Effects Center for a complete guide to possible side effects »

What is the most important information I should know about nasal cyanocobalamin (Nascobal)?

You should not use this medication if you are allergic to cobalt, or if you have Leber's disease. Cyanocobalamin can lead to optic nerve damage (and possibly blindness) in people with Leber's disease.

To treat pernicious anemia, you will have to use this medication on a regular basis for the rest of your life. Not using the medication can lead to irreversible nerve damage in your spinal cord.

Pernicious anemia is also treated with folic acid to help maintain red blood cells. However, folic acid will not treat Vitamin B12 deficiency and will not prevent possible damage to the spinal cord. Use all of your medications as directed.

Avoid eating or drinking hot foods or liquids within 1 hour before or after using the nasal form of this medication.

Tell your doctor if you develop nasal congestion, a cold, or allergies. The nasal spray may not work as well if you are congested.

Your dose needs may change if you become pregnant, if you breast-feed, or if you eat a vegetarian diet. Tell your doctor about any changes in your diet or medical condition.