← Search & browse all drugs
BLOOD AND BLOOD FORMING ORGANS › ANTIANEMIC PREPARATIONS › VITAMIN B12 AND FOLIC ACID › Vitamin B12 (cyanocobalamin and analogues)
hydroxocobalamin
B03BA03
Forms & Strengths
- Injection: 1000 mcg/mL in 30 mL vials
- Kit (Cyanokit): 5 g lyophilized powder in single-dose vial for reconstitution
Adult Dosing
- Vitamin B12 deficiency: 1000 mcg IM daily for 1 week, then weekly for 1 month, then monthly for maintenance
- Cyanide poisoning: 5 g IV infusion over 15 minutes; may repeat once up to 10 g total based on severity and clinical response
Pediatric Dosing
- Vitamin B12 deficiency (pernicious anemia): 100 mcg IM daily or every other day for 2 weeks (total 1-5 mg), then 60 mcg monthly
- Cyanide poisoning: 70 mg/kg (up to 5 g) IV infusion over 15 minutes; may repeat once up to 140 mg/kg (10 g) total
Indications
- Treatment of Vitamin B12 deficiency (pernicious anemia, malabsorption)
- Treatment of known or suspected cyanide poisoning
Mechanism of Action
- Acts as a coenzyme for metabolic functions including methionine synthesis and myelin synthesis
- Binds cyanide ions with high affinity to form cyanocobalamin, which is then excreted safely in the urine
Contraindications
- Hypersensitivity to hydroxocobalamin or cobalt
- Pre-existing sensitivity to cyanocobalamin
Adverse Reactions
- Chromaturia (red-orange urine discoloration)
- Transient hypertension and tachycardia
- Skin erythema and acneiform rash
- Allergic reactions including anaphylaxis
- Injection site pain and irritation
Drug Interactions
- Chloramphenicol may antagonize the hematopoietic response to vitamin B12
- Incompatible in solution with multiple drugs; do not mix in the same IV line (especially diazepam, dobutamine, dopamine)
Curated Content: Needs Vetting Before Put to Clinical Use