Instructions for use CYANOCOBALAMIN
Adults.
SC for Addison-Birmer anemia - 100-200 mcg/day every other day; for funicular myelosis, macrocytic anemia with dysfunction of the nervous system - 400-500 mcg/day in the first week - daily, then at intervals between administrations of up to 5-7 days (folic acid is prescribed at the same time); during the period of remission, a maintenance dose of 100 mcg/day 2 times a month, in the presence of neurological phenomena - 200-400 mcg 2-4 times a month.
For acute posthemorrhagic and iron deficiency anemia - 30-100 mcg 2-3 times a week, for aplastic anemia - 100 mcg until clinical and hematological improvement occurs.
For diseases of the central and peripheral nervous system, neurological diseases with pain, it is administered in increasing doses - 200-500 mcg/day until pain relief, then 100 mcg/day for 2 weeks. For traumatic lesions of the peripheral nervous system - 200-400 mcg every other day for 40-45 days.
For hepatitis and cirrhosis of the liver - 30-60 mcg/day or 100 mcg every other day for 25-40 days.
For acute radiation sickness, diabetic neuropathy - 60-100 mcg daily for 20-30 days.
For funicular myelosis, amyotrophic lateral sclerosis, multiple sclerosis - 15-30 mcg intralumbarally, and with each subsequent injection the dose is increased (50, 100, 150, 200 mcg). Intralumbar injections are given every 3 days, a total of 8-10 injections are required per course. During the period of remission in the absence of manifestations of funicular myelosis, 100 mcg twice a month is prescribed for maintenance therapy, in the presence of neurological symptoms - 200-400 mcg 2-4 times a month.
To eliminate cyanocobalamin deficiency, the following is administered intramuscularly or intravenously:
- for treatment 1 mg daily for 1-2 weeks, maintenance dose 1-2 mg from 1 time per week to 1 time per month;
- for prevention - 1 mg once a month. The duration of treatment is determined individually.
Children.
Administered subcutaneously at a dose of 1 mcg/kg, the maximum daily dose is 100 mcg. For nutritional anemia and anemia in premature infants - subcutaneously 30 mcg per day daily for 15 days, for aplastic anemia - 100 mcg until clinical and hematological improvement occurs.
For degenerative conditions after illness, Down's disease and cerebral palsy - 15-30 mcg subcutaneously every other day.
For hepatitis and cirrhosis of the liver, take 30-60 mcg/day or 100 mcg every other day for 25-40 days.
Doses and regimen of use depend on the pathology and range from 30 mcg to 100 mcg/day. The 500 mcg/ml dosage form is not used in children under 3 years of age.
Cyanocobalamin, solution
Cyanocobalamin is administered subcutaneously, intramuscularly, intravenously, and for funicular myelosis and amyotrophic lateral sclerosis - intralumbarally.
Adults
Subcutaneously for Addison-Biermer anemia – 100–200 mcg/day every other day; for funicular myelosis, macrocytic anemia with dysfunction of the nervous system - 400-500 mcg/day in the first week - daily, then at intervals between administrations of up to 5-7 days (folic acid is prescribed at the same time); during the period of remission, a maintenance dose of 100 mcg/day 2 times a month, in the presence of neurological phenomena - 200-400 mcg 2–4 times a month.
For acute posthemorrhagic and iron deficiency anemia - 30-100 mcg 2-3 times a week, for aplastic anemia - 100 mcg until clinical and hematological improvement occurs.
For diseases of the central and peripheral nervous system, neurological diseases with pain, it is administered in increasing doses - 200–500 mcg/day until pain relief, then 100 mcg/day for 2 weeks. For traumatic lesions of the peripheral nervous system - 200–400 mcg every other day for 40–45 days.
For hepatitis and cirrhosis of the liver - 30–60 mcg/day or 100 mcg every other day for 25–40 days.
For acute radiation sickness, diabetic neuropathy – 60–100 mcg daily for 20–30 days.
For funicular myelosis, amyotrophic lateral sclerosis, multiple sclerosis - 15-30 mcg intralumbarally, and with each subsequent injection the dose is increased (50 mcg, 100 mcg, 150 mcg, 200 mcg). Intralumbar injections are given every 3 days, a total of 8-10 injections are required per course. During the period of remission in the absence of manifestations of funicular myelosis, 100 mcg twice a month is prescribed for maintenance therapy, in the presence of neurological symptoms - 200–400 mcg 2–4 times a month.
To eliminate cyanocobalamin deficiency, it is administered intramuscularly or intravenously: for treatment, 1 mg daily for 1–2 weeks, maintenance dose 1–2 mg from 1 time per week to 1 time per month; for prevention – 1 mg once a month. The duration of treatment is determined individually.
Children
Administered subcutaneously at a dose of 1 mcg/kg, the maximum daily dose is 100 mcg. For nutritional anemia and anemia in premature babies - 30 mcg per day subcutaneously for 15 days, for aplastic anemia - 100 mcg until clinical and hematological improvement occurs.
For degenerative conditions after illness, Down's disease and cerebral palsy - 15-30 mcg subcutaneously every other day.
Doses and mode of administration depend on the pathology and range from 30 mcg to 100 mcg per day. The 500 mcg/ml dosage form is not used in children under 3 years of age.
What is vitamin B12, release forms
Vitamin B12 is a representative of the water-soluble group of vitamins, can accumulate and be stored in the liver, and contains cobalt.
It is necessary for the human body, as it takes part in hematopoiesis and the production of red blood cells. The source is animal products - dairy and meat products, chicken eggs. As a rule, vegetarians, pregnant women, as well as people diagnosed with atrophic gastritis or chronic enteritis suffer from cyanocobalamin deficiency. The cause of a lack of vitamin B12 may be pathologies that prevent its absorption in the intestines.
To compensate for the lack of cyanocobalamin in the population, pharmaceutical factories produce a variety of drugs containing either one component or a combination of essential vitamins and minerals (vitamin complexes).
You can buy vitamin B12 in pharmacies in several dosage forms:
- capsules for oral administration;
- film-coated tablets;
- solution for injection.
Indications
Chronic anemia occurring with cyanocobalamin deficiency (Addison-Birmer disease, alimentary macrocytic anemia), as well as in the complex treatment of iron deficiency, posthemorrhagic and aplastic anemia, anemia caused by toxic substances and/or drugs.
Diseases of the nervous system: polyneuritis, radiculitis, causalgia and neuralgia (including trigeminal neuritis), amyotrophic lateral sclerosis, peripheral nerve injuries, funicular myelosis, cerebral palsy, Down's disease.
Skin diseases (psoriasis, photodermatosis, dermatitis herpetiformis, atopic dermatitis).
Chronic hepatitis, liver cirrhosis, liver failure.
Acute radiation sickness.
For prophylactic purposes - when prescribing biguanides, para-aminosalicylic acid, ascorbic acid in high doses, pathology of the stomach and intestines with impaired absorption of cyanocobalamin (resection of part of the stomach, small intestine, Crohn's disease, celiac disease, malabsorption syndrome, sprue).
Cyanocobalamin (Vitamin B_12) 500 mcg/ml No. 10 solution for intravenous amp.
Instructions for medical use of the drug Cyanocobalamin Trade name Cyanocobalamin International nonproprietary name Cyanocobalamin Dosage form Solution for injection 500 mcg/ml Composition One ampoule (1 ml) contains: active ingredient: cyanocobalamin – 500 mcg; excipients: sodium chloride, water for injection. Description Transparent red liquid. Pharmacotherapeutic group Hematopoiesis stimulants. Vitamin B12 and folic acid. Cyanocobalamin and its derivatives. Cyanocobalamin. ATC code B03BA01 Pharmacological properties Pharmacokinetics Connection with plasma proteins - 90%. The maximum concentration (Cmax) after subcutaneous and intramuscular administration is reached after 1 hour. In the blood, vitamin B12 binds to transcobalamins I and II, which transport it to the tissues. Deposited mainly in the liver. It is excreted from the liver with bile into the intestines and reabsorbed into the blood. The half-life (T1/2) in the liver is 500 days. Excreted with normal renal function - 7-10% by the kidneys, about 50% - with feces; with reduced renal function - 0-7% by the kidneys, 70-100% - by feces. Penetrates through the placental barrier into breast milk. Pharmacodynamics Cyanocobalamin (Vitamin B12) has a metabolic, hematopoietic effect. In the body (mainly in the liver) it is converted into methylcobalamin and 5-deoxyadenosylcobalamin. Methylcobalamin is involved in the conversion of homocysteine to methionine and S-adenosylmethionine - key reactions in the metabolism of pyrimidine and purine bases (and, consequently, DNA and RNA). If there is insufficiency of the vitamin in this reaction, it can be replaced by methyltetrahydrofolic acid, and folate-requiring metabolic reactions are disrupted. 5-deoxyadenosylcobalamin serves as a cofactor in the isomerization of L-methylmalonyl-CoA to succinyl-CoA, an important reaction in carbohydrate and lipid metabolism. Vitamin B12 deficiency leads to impaired proliferation of rapidly dividing cells of hematopoietic tissue and epithelium, as well as impaired formation of the myelin sheath of neurons. Indications for use: chronic anemia occurring with cyanocobalamin deficiency (Addison-Biermer disease, alimentary macrocytic anemia). As part of complex therapy, polyneuritis, radiculitis, neuralgia (including trigeminal neuralgia), malnutrition, injuries to peripheral nerves. - skin diseases (psoriasis, photodermatosis, dermatitis herpetiformis, atopic dermatitis). For prophylactic purposes - when prescribing biguanides, para-aminosalicylic acid, ascorbic acid in high doses, pathology of the stomach and intestines with impaired absorption of cyanocobalamin (resection of part of the stomach, small intestine, Crohn's disease, celiac disease, malabsorption syndrome, sprue), malignant tumors of the pancreas and intestines Method of administration and dosage Subcutaneously Adults For Addison-Birmer anemia - 100-200 mcg/day (0.2-0.4 ml) every other day; for funicular myelosis, macrocytic anemia with dysfunction of the nervous system - 400 - 500 mcg / day (0.8-1 ml) in the first week - daily, then at intervals between administrations of up to 5 - 7 days (folic acid is prescribed at the same time); during the period of remission, a maintenance dose of 100 mcg/day (0.2 ml) 2 times a month, in the presence of neurological phenomena - 200 - 400 mcg (0.4-0.8 ml) 2 - 4 times a month. For diseases of the central and peripheral nervous system, neurological diseases with pain syndrome, it is administered in increasing doses. Adults - 200 - 500 mcg / day (0.4 -1 ml) until pain relief, then 100 mcg / day for 2 weeks. For traumatic lesions of the peripheral nervous system - 200 - 400 mcg every other day for 40 - 45 days. Intramuscularly or intravenously To eliminate cyanocobalamin deficiency, the following is administered: for treatment - 1 mg (2 ml) daily for 1 - 2 weeks, maintenance dose 1 - 2 mg (2-4 ml) from 1 time per week to 1 time per month; for prevention - 1 mg (2ml) once a month. The duration of treatment is determined individually. Children The 500 mcg/ml dosage form is used for children over 3 years of age. Doses and mode of administration depend on the pathology and range from 30 mcg to 100 mcg per day. Administered subcutaneously at a dose of 1 mcg/kg, the maximum daily dose is 100 mcg (0.2 ml). For various forms of hypo-aplastic, nutritional anemia in children, the drug is prescribed at the age of 3 to 4 years, 15-50 mcg (0.1 ml), over 4 years, 50 - 100 mcg (0.1 ml). – 0.2 ml), daily for 15 days or until clinical and hematological improvement occurs. For dystrophic conditions after long-term illnesses, 15-30 mcg subcutaneously every other day. Side effects Rarely - state of agitation, headache, dizziness - cardialgia, tachycardia - urticaria, rash, itching, anaphylactic shock, Quincke's edema - compaction and necrosis at the injection site Frequency unknown - diarrhea, nausea - pain at the injection site - acne, bullous rash , eczema - swelling, sweating, weakness, fever, red color of urine (due to excretion of vitamin B12) when used in high doses - hypercoagulation, disturbance of purine metabolism Contraindications - hypersensitivity to the active substance (cyanocobalamin) - thromboembolism, tendency to form blood clots - erythremia , erythrocytosis - pregnancy (there are separate indications of the possible teratogenic effect of B vitamins in high doses), lactation period - children under 3 years of age (for this dosage form) - Leber's disease, nicotinic amblyopia (increases the risk of neurodegenerative damage to the optic nerve) - angina pectoris voltage FC III - benign and malignant neoplasms (except for cases accompanied by megaloblastic anemia and vitamin B12 deficiency) Drug interactions Pharmaceutically incompatible with ascorbic acid, heavy metal salts (inactivation of cyanocobalamin), thiamine bromide, pyridoxine, riboflavin (since The cobalt ion contained in the cyanocobalamin molecule destroys other vitamins). Aminoglycosides, polymyxin, tetracyclines, salicylates, antiepileptic drugs, colchicine, potassium preparations reduce the absorption of cyanocobalamin. Cyanocobalamin enhances the development of allergic reactions caused by thiamine. Chloramphenicol reduces the hematopoietic response. Do not combine with drugs that increase blood clotting. Citamen: when used simultaneously with cyanocobalamin, the effect of citamen is reduced. Oral contraceptives - reduce the concentration of cyanocobalamin in the blood. Antimetabolites and most antibiotics change the results of microbiological studies of cyanocobalamin. Special instructions Cyanocobalamin deficiency should be confirmed diagnostically before prescribing the drug, since it may mask folic acid deficiency. During the treatment period, it is necessary to monitor peripheral blood parameters: on the 5-8th day of treatment, the number of reticulocytes and iron concentration are determined. The number of red blood cells, hemoglobin and color indicator must be monitored for 1 month 1-2 times a week, and then 2-4 times a month. Remission is achieved when the number of erythrocytes increases to 4-4.5 million/μl, when the normal size of erythrocytes is reached, aniso- and poikilocytosis disappears, and the number of reticulocytes normalizes after a reticulocyte crisis. After achieving hematological remission, peripheral blood monitoring is carried out at least once every 4-6 months. If there is a tendency to develop leuko- and erythrocytosis, the dose of the drug should be reduced or treatment with the drug should be temporarily stopped. Use caution in persons prone to thrombus formation with angina pectoris (doses should be reduced, not more than 100 mcg per injection). When used in recommended doses in elderly people, no adverse reactions other than those listed above were observed. In cases of adverse reactions, the use of cyanocobalamin is temporarily stopped or discontinued. If necessary, treatment is resumed, starting with small doses - 50 mcg. Each ampoule of this drug contains 3.5 mg of sodium in the form of salts. This should be taken into account in patients who control their intake of sodium salts. Use in pediatrics The drug can be used in children over 3 years of age. Pregnancy and lactation There are separate indications of the possible teratogenic effect of B vitamins in high doses, so the use of the drug is not recommended. Cyanocobalamin is excreted in breast milk, so use during lactation is not recommended or breastfeeding should be stopped during treatment. Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous mechanisms Considering the side effects of the drug, caution should be exercised when driving vehicles and doing work that requires concentration. Overdose When using cyanocobalamin in therapeutic doses, overdose has not been reported. Symptoms of overdose (possible): pulmonary edema, congestive heart failure, peripheral vascular thrombosis, urticaria, and less commonly, anaphylactic shock. Treatment is symptomatic. Release form and packaging 1 ml in glass ampoules. 10 ampoules, along with a knife or scarifier for opening the ampoules, are placed in a cardboard box with a corrugated paper liner. The box is covered with a label made of paper for multicolor printing. The boxes, together with instructions for medical use in the state and Russian languages, are packed in group packaging. The number of instructions for medical use must correspond to the number of packages. 10 ampoules in a polyvinyl chloride film insert. 1 insert, along with a knife or scarifier for opening ampoules and instructions for medical use in the state and Russian languages, is placed in a pack of chrome-ersatz cardboard. 10 ampoules, along with a knife or scarifier for opening the ampoules and instructions for medical use in the state and Russian languages, are placed in a pack of cardboard with a cardboard insert for fixing the ampoules. Packs are packed in group packaging. In the case of using ampoules with a break ring or with a notch and a break point, the insertion of a knife or scarifier for opening the ampoules is not provided. Storage conditions Store in a place protected from light, at a temperature not exceeding 25 ºС. Keep out of the reach of children. Shelf life: 2 years Do not use after expiration date. Conditions for dispensing from pharmacies By prescription Manufacturer Open joint-stock company “Borisov Medical Preparations Plant”, Republic of Belarus, Minsk region, Borisov, st. Chapaeva, 64/27, tel/fax 8-(10375177)744280. Owner of the registration certificate Open Joint-Stock Company "Borisov Plant of Medical Preparations", Republic of Belarus Address of the organization that accepts claims from consumers regarding the quality of products (products) in the territory of the Republic of Kazakhstan Open Joint-Stock Company "Borisov Plant of Medical Preparations", Republic of Belarus, Minsk region, Borisov, st. Chapaeva, 64/27, tel/fax 8-(10375177) 744280, email address
B12 from Blagomin
Available in the form of capsules of 0.2 g. One jar contains 90 pieces. In addition to the main active ingredient, it contains gelatin and microcrystalline cellulose.
The intake is indicated to replenish the lack of cyanocobalamin in the body. Also contraindicated for pregnant and lactating women, persons with intolerance to substances from the composition.
The instructions prescribe taking one capsule once a day for a month. Allowed for teenagers over 14 years of age and adults. You can undergo treatment courses several times a year.
The price for a jar starts from 240 rubles, a prescription is not needed to purchase.
Contraindications
Hypersensitivity to the components of the drug, thromboembolism, erythremia, erythrocytosis, pregnancy (there are separate indications of the possible teratogenic effect of B vitamins in high doses), lactation period, children under 3 years of age for this dosage form. Leber's disease, nicotine amblyopia (increases the risk of neurodegenerative damage to the optic nerve).
Angina pectoris FC III, benign and malignant neoplasms (except for cases accompanied by megaloblastic anemia and vitamin B12 deficiency), tendency to form blood clots.
special instructions
Vitamin B12 deficiency should be confirmed diagnostically before prescribing the drug, as it may mask folic acid deficiency.
During the treatment period, it is necessary to monitor peripheral blood parameters: on the 5-8th day of treatment, the number of reticulocytes and Fe concentration are determined. The number of red blood cells, Hb and color index must be monitored for 1 month 1-2 times a week, and then 2-4 times a month.
Remission is achieved when the number of erythrocytes increases to 4-4.5 million/μl, when the normal size of erythrocytes is reached, aniso- and poikilocytosis disappears, and the number of reticulocytes normalizes after a reticulocyte crisis. After hematological remission is achieved, peripheral blood monitoring is carried out at least once every 4-6 months.
Use caution in persons prone to thrombus formation with angina pectoris (in lower doses, up to 0.1 mg per injection). Take for a long time for pernicious anemia, upcoming operations on the gastrointestinal tract.
When used in recommended doses in elderly people, no adverse reactions other than those listed above were observed.
What is vitamin B12 for?
First of all, vitamin B12 is needed for the normal functioning of the hematopoietic system, since the substance is necessary for the maturation of red blood cells. Helps prevent anemia. Also cyanocobalamin:
- takes part in providing the body with energy;
- necessary for the reproduction of cells in the bone marrow, nervous system and gastrointestinal tract;
- helps the nervous system work smoothly;
- ensures iron absorption;
- has an analgesic effect;
- needed for metabolism (participates in the metabolism of proteins, fats and carbohydrates);
- serves as a prevention of Alzheimer's disease, depression, schizophrenia, and cardiovascular pathologies.
Drug interactions
Pharmaceutically incompatible with ascorbic acid, heavy metal salts (inactivation of cyanocobalamin), thiamine bromide, pyridoxine, riboflavin (since the cobalt ion contained in the cyanocobalamin molecule destroys other vitamins).
Aminoglycosides, salicylates, antiepileptic drugs, colchicine, K+ drugs reduce absorption. Strengthens the development of allergic reactions caused by thiamine.
Chloramphenicol reduces the hematopoietic response.
Cannot be combined with drugs that increase blood clotting.
The risk of developing allergic reactions due to thiamine.
