Cyanocobalamin
Cyanocobalamin: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. Drug interactions
- 12. Analogs
- 13. Terms and conditions of storage
- 14. Terms of dispensing from pharmacies
- 15. Reviews
- 16. Price in pharmacies
Latin name: Cyanocobalamin
ATX code: B03BA01
Active ingredient: cyanocobalamin (cyanocobalamin)
Manufacturer: Ozone, LLC (Russia), Moskhimpharmpreparaty them. N. A. Semashko, JSC (Russia), Borisov Plant of Medicines, JSC (Republic of Belarus), Yerevan Chemical-Pharmaceutical Firm, JSC (Armenia)
Description and photo update: 2018-13-07
Prices in pharmacies: from 24 rubles.
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Cyanocobalamin (vitamin B 12) is a drug that has a hematopoietic effect that stimulates cell metabolism.
Release form and composition
Cyanocobalamin is released in the form of a solution for injection: a clear liquid from pale pink to bright pink (dosage 0.2 mg) or from bright pink to bright red (dosage 0.5 mg) (1 ml in a glass ampoule: in a blister pack or in a cardboard tray 5 ampoules, in a cardboard box 1 or 2 packs / tray; in a blister pack 10 ampoules, in a cardboard box 1 or 2 blister packs; in a contour plastic package 5 or 10 ampoules, in a cardboard box 1 or 2 plastic packaging; 10 ampoules in a carton pack; in the absence of a break ring or a notch and a break point on the ampoules, a scarifier or a knife for opening the ampoules is put into the carton pack).
1 ampoule of Cyanocobalamin (1 ml of solution) contains:
- active substance: cyanocobalamin - 0.2 or 0.5 mg;
- additional components: water for injection, sodium chloride.
Pharmacological properties
Pharmacodynamics
Vitamin B 12 (cyanocobalamin) has metabolic and hematopoietic effects. In the body (mainly in the liver), the active substance is converted into a coenzyme form - adenosylcobalamin, or cobamamide. The latter is the active form of vitamin B 12 and is included in a large number of enzymes, including in the composition of reductase, which reduces folic acid to tetrahydrofolic acid in the body. Cyanocobalamin has a high biological activity.
Since cobamamide is involved in the transfer of methyl and other one-carbon fragments, it is required for the formation of DNA and deoxyribose, creatine and methionine, which is a donor of methyl groups. Cobamamide is necessary for the production of one of the important lipotropic factors - choline, for the transformation of methylmalonic acid into succinic acid, which belongs to the components of myelin, and also for the elimination of propionic acid from the body.
By promoting the maturation of erythrocytes, the substance ensures normal blood formation. The drug promotes the deposition of compounds containing sulfhydryl groups in erythrocytes, thereby increasing their tolerance to hemolysis. Improves the work of the blood coagulation system, when used in high doses leads to an increase in the activity of prothrombin and thromboplastin. Cyanocobalamin increases the ability of tissues to regenerate, lowers the concentration of cholesterol in the blood, and has a beneficial effect on the activity of the nervous system and liver.
The daily requirement for vitamin B 12, taking into account the age and sex of the patient, is:
- 0.3-1.4 mg - for children (depending on age);
- 1-2 mg - for adult men and women (during pregnancy, more by 0.5 mg, during lactation - by 0.6 mg);
- 1.2-1.4 mg - for the elderly.
Pharmacokinetics
Cyanocobalamin is absorbed throughout the small intestine, and only a small amount is absorbed in the large intestine. In the blood, cyanocobalamin binds to type I and type II transcobalamins, which transport it to tissues. The substance is deposited mainly in the liver, binds to proteins by 90%. After intramuscular and subcutaneous administration, the maximum concentration of the active substance is noted after 1 hour.
Cyanocobalamin is excreted from the liver with bile into the intestines and again absorbed into the blood, the half-life is 500 days. With normal renal function, 7-10% of the substance is excreted in the urine and about 50% in the feces, with impaired renal function - 0-7% in the urine and 70-100% in the feces. The agent passes through the placental barrier and enters breast milk.
Indications for use
According to the instructions, Cyanocobalamin is recommended for use for the treatment of the following diseases / conditions:
- conditions accompanied by a deficiency of vitamin B 12: chronic anemia associated with a deficiency of vitamin B 12 - alimentary macrocytic anemia, Addison-Birmer disease; as part of a combination treatment - post-hemorrhagic, aplastic, iron deficiency anemia, as well as anemia caused by drugs and / or toxic substances;
- liver damage: as part of a combination therapy - cirrhosis of the liver, liver failure, chronic hepatitis, alcoholism (prolonged fever);
- neurological diseases: neuralgia (including trigeminal neuralgia), radiculitis, polyneuritis, hypotrophy, funicular myelosis, amyotrophic lateral sclerosis, peripheral nerve trauma, Down's disease, cerebral palsy;
- skin diseases: atopic dermatitis, photodermatosis, dermatitis herpetiformis, psoriasis.
For prophylaxis, Cyanocobalamin is recommended for use in the following conditions / diseases:
- taking paraaminosalicylic acid (PASK), biguanides, ascorbic acid in high doses;
- intestinal and stomach pathologies leading to impaired absorption of vitamin B 12 (malabsorption syndrome, Crohn's disease, sprue, resection of a part of the stomach, small intestine);
- diarrhea, enteritis;
- radiation sickness.
Contraindications
Absolute:
- erythrocytosis;
- erythremia;
- thromboembolism;
- pregnancy and lactation;
- hypersensitivity to the constituents of the product.
Relative (Cyanocobalamin should be used with caution):
- megaloblastic anemia and vitamin B 12 deficiency against the background of benign and malignant neoplasms;
- angina pectoris;
- predisposition to thrombosis.
Instructions for the use of Cyanocobalamin: method and dosage
Cyanocobalamin in ampoules is administered intravenously (intravenously), intramuscularly (intramuscularly), subcutaneously (subcutaneously) and intralumbar.
The recommended dosage regimen of Cyanocobalamin, depending on the indications:
- Addison-Birmer's anemia: s / c every other day, 0.1–0.2 mg per day;
- funicular myelosis and macrocytic anemias with dysfunction of the nervous system: in the first week, daily s / c at 0.4–0.5 mg per day, then at intervals between injections up to 5–7 days (in combination with folic acid); a maintenance dose during remission is administered 2 times a month at 0.1 mg per day, and in the presence of neurological phenomena - 2–4 times a month at 0.2–0.4 mg;
- vitamin B 12 deficiency: i / v or i / m daily, 1 mg for 7-14 days; for prophylaxis - i / v or i / m 1 time per month, 1 mg;
- diseases of the peripheral nervous system of traumatic genesis: every other day, 0.2–0.4 mg for 40–45 days;
- lesions of the central and peripheral nervous system: every other day, 0.2–0.5 mg for 14 days;
- acute iron deficiency and post-hemorrhagic anemia: 2-3 times a week, 0.03-0.1 mg;
- aplastic anemia: 0.1 mg to observe clinical and hematological improvement; in the presence of disorders of the nervous system - 2-4 times a month, 0.2-0.4 mg;
- cirrhosis of the liver, hepatitis: every other day, 0.1 mg or daily, 0.03–0.06 mg for 25–40 days;
- radiation sickness: 0.06-0.1 mg daily for 20-30 days;
- amyotrophic lateral sclerosis, funicular myelosis: intralumbar (in the spinal canal) 0.015–0.03 mg with a gradual increase in the dose to 0.2–0.25 mg per injection;
- alimentary anemia (infants, premature infants): s / c 0.03 mg daily for 15 days;
- dystrophies in young children, Down's disease, infantile cerebral palsy: s / c every other day, 0.015–0.03 mg.
Side effects
During therapy with Cyanocobalamin, the following undesirable effects may occur: dizziness, headache, diarrhea, tachycardia, cardialgia, nervous excitement, allergic reactions (including skin itching, rash); extremely rare - anaphylaxis; when using high doses - violation of purine metabolism, hypercoagulation.
Overdose
In case of an overdose of vitamin B 12, disorders such as urticaria, congestive heart failure, pulmonary edema, peripheral vascular thrombosis, and anaphylactic shock may occur. If an overdose is suspected, the drug should be discontinued and symptomatic treatment should be carried out.
special instructions
Before the appointment of Cyanocobalamin, its deficiency should be established diagnostically, since it can mask the lack of folic acid.
During the period of therapy, it is required to monitor the parameters of peripheral blood: on the 5-8th day of the course, the level of reticulocytes and iron concentration should be determined. During the first month of treatment, 1-2 times a week, and subsequently - 2-4 times a month, it is necessary to monitor the number of erythrocytes, hemoglobin level, color indicator.
Remission is achieved with an increase in the number of erythrocytes to 4–4.5 million / μl and their normal size, with the elimination of anisocytosis and poikilocytosis, as well as with normalization of the level of reticulocytes after the onset of reticulocytic crisis. Against the background of reaching hematological remission, peripheral blood parameters must be determined at least once every 4–6 months.
If there is angina pectoris and a tendency to form blood clots, Cyanocobalamin should be used in doses up to 0.1 mg per administration.
It is recommended to use the drug for a long time against the background of pernicious anemia, as well as during operations on the gastrointestinal tract.
At the beginning of therapy for megaloblastic anemia, cases of arrhythmia secondary to hypokalemia were recorded, as a result of which it is required to control the concentration of potassium in this period.
When using Cyanocobalamin in elderly patients, no adverse reactions other than those indicated above were observed.
Most antibacterials and antimetabolites can interfere with the microbiological assay for vitamin B 12.
Influence on the ability to drive vehicles and complex mechanisms
There is no information confirming the adverse effect of the product on the ability to drive vehicles and control complex mechanisms. However, given that Cyanocobalamin can lead to dizziness, caution is required when performing these activities.
Application during pregnancy and lactation
There is some evidence of the potential teratogenic effect of B vitamins when used in high doses. The introduction of Cyanocobalamin during pregnancy and breastfeeding is contraindicated.
Pediatric use
The use of Cyanocobalamin in children is possible according to the dosage regimen.
Drug interactions
- heavy metal salts, ascorbic acid, thiamine bromide, pyridoxine, riboflavin are pharmaceutically incompatible with vitamin B 12, since the cobalt ion, which is part of the latter molecule, destroys other vitamins; when combined with heavy metal salts, cyanocobalamin is inactivated;
- drugs that increase blood clotting - this combination is contraindicated;
- antiepileptic drugs, colchicine, salicylates, aminoglycosides, potassium preparations - absorption of vitamin B 12 decreases;
- chloramphenicol - hematopoietic response decreases;
- thiamine - the risk of allergic reactions is aggravated;
- folic acid - the toxic effect increases.
Analogs
Cyanocobalamin analogs are: Cyanocobalamin bufus, Cyanocobalamin-Vial, Tsikomin-Altpharm.
Terms and conditions of storage
Store out of the reach of children and protected from light, at a temperature not exceeding 25 ° C.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Cyanocobalamin
According to many reviews, Cyanocobalamin is an effective drug used to improve well-being, increase hemoglobin levels, and normalize sleep. Patients indicate that the remedy helps to strengthen the immune system, reduce pain with inflammation of the trigeminal nerve and neuralgia, improve blood circulation and hematopoiesis. Many patients note the high effectiveness of Cyanocobalamin when used to accelerate the growth of nails and hair. Often the solution is used as a component of masks or in pure form for rubbing into hair roots, which leads to strengthening of the latter, reducing hair loss and appearance of shine, and disappearing dandruff.
Lack of vitamin B 12 is considered the possible appearance of side effects in the form of allergic reactions. Sometimes they complain that the neck of the ampoule is rather difficult to saw off.
The price of Cyanocobalamin in pharmacies
The price of Cyanocobalamin solution for injection (0.5 mg / ml) can be 23-35 rubles for 10 ampoules.
Cyanocobalamin: prices in online pharmacies
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Drug name Price Pharmacy |
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Cyanocobalamin 0.5 mg / ml injection 1 ml 10 pcs. RUB 24 Buy |
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Cyanocobalamin 0.5 mg / ml injection 1 ml 10 pcs. RUB 26 Buy |
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Cyanocobalamin 0.5 mg / ml injection 1 ml 10 pcs. 28 RUB Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
