Vitamin b12 pill side effects. Vitamin B12 Supplements: Essential Benefits and Potential Side Effects
What are the key benefits of vitamin B12 supplements. How much vitamin B12 should you take daily. What are the potential side effects of excessive vitamin B12 intake. Who is at risk of vitamin B12 deficiency. How can you ensure adequate vitamin B12 levels through diet alone.
Understanding Vitamin B12: Functions and Importance
Vitamin B12, also known as cobalamin, is a crucial nutrient that plays a vital role in various bodily functions. This water-soluble vitamin is essential for DNA synthesis, red blood cell formation, and proper neurological function. While most people obtain sufficient amounts of vitamin B12 through their diet, some individuals may require supplements to maintain optimal levels.
The human body’s ability to absorb and utilize vitamin B12 efficiently makes it an indispensable component of overall health. Its primary functions include:
- Supporting the formation of red blood cells
- Aiding in DNA synthesis and cell division
- Maintaining proper nervous system function
- Contributing to energy metabolism
- Assisting in the production of neurotransmitters
Recommended Daily Intake of Vitamin B12
The recommended daily intake of vitamin B12 varies depending on age, gender, and life stage. According to the National Institutes of Health, the following guidelines apply:
- Adults (14 years and older): 2.4 micrograms (mcg) daily
- Pregnant women: 2.6 mcg daily
- Breastfeeding women: 2.8 mcg daily
For individuals over 50 years of age, it is recommended to obtain the daily requirement through fortified foods or supplements, as the ability to absorb vitamin B12 from natural sources may decrease with age. A supplement containing 25 to 100 mcg of B12 is generally considered suitable for this age group.
Can you consume too much vitamin B12?
While vitamin B12 is generally considered safe, excessive intake can lead to potential side effects. The body’s ability to store unused vitamin B12 in the liver means that taking supplements may result in ingesting more than necessary. It’s important to note that the risk of overdose is primarily associated with high-dose supplements rather than dietary sources.
Potential Side Effects of Vitamin B12 Supplements
While vitamin B12 supplements are generally safe when taken as directed, some individuals may experience side effects, particularly when consuming high doses or receiving injectable forms of the vitamin. Common side effects may include:
- Mild diarrhea
- Itching or skin rash
- Headache
- Dizziness
- Nausea and vomiting
- Sensation of swelling
In rare cases, more severe side effects may occur, such as:
- Pulmonary edema and congestive heart failure (early in treatment)
- Vein thrombosis
- Polycythemia vera (a rare, slow-growing blood cancer)
Are there any serious allergic reactions to vitamin B12?
Although extremely rare, vitamin B12 can cause severe allergic reactions (anaphylaxis) in some individuals. Symptoms of anaphylaxis may include swelling of the face, tongue, and throat, as well as difficulty swallowing and breathing. If you experience these symptoms after taking vitamin B12, seek emergency medical attention immediately.
Identifying Vitamin B12 Deficiency: Symptoms and Risk Factors
Vitamin B12 deficiency can lead to various health issues if left untreated. Recognizing the symptoms and understanding the risk factors is crucial for early detection and appropriate intervention. Common symptoms of vitamin B12 deficiency include:
- Fatigue and weakness
- Pale or jaundiced skin
- Shortness of breath
- Heart palpitations
- Numbness or tingling in extremities
- Balance problems and dizziness
- Mood changes and depression
- Cognitive difficulties and memory problems
Certain groups of people are at a higher risk of developing vitamin B12 deficiency:
- Older adults (over 50 years old)
- Vegetarians and vegans
- Individuals with gastrointestinal disorders (e.g., Crohn’s disease, celiac disease)
- People who have undergone weight loss surgery
- Those with pernicious anemia
- Individuals taking certain medications (e.g., metformin, proton pump inhibitors)
How is vitamin B12 deficiency diagnosed?
Vitamin B12 deficiency is typically diagnosed through blood tests that measure serum B12 levels. In some cases, additional tests may be necessary to assess methylmalonic acid (MMA) and homocysteine levels, which can provide more accurate information about B12 status. If you suspect a deficiency, consult your healthcare provider for proper evaluation and diagnosis.
Natural Sources of Vitamin B12: Incorporating B12-Rich Foods into Your Diet
While supplements can be beneficial for those with deficiencies, obtaining vitamin B12 from natural food sources is generally recommended for most individuals. Incorporating B12-rich foods into your diet can help ensure adequate intake and reduce the need for supplements. Some excellent dietary sources of vitamin B12 include:
- Eggs
- Cheese
- Fish (particularly salmon, trout, and tuna)
- Shellfish (clams, oysters, and mussels)
- Liver
- Kidney
- Red meat (beef, lamb)
- Fortified plant-based milk alternatives
- Fortified breakfast cereals
- Nutritional yeast
How can vegetarians and vegans ensure adequate B12 intake?
For vegetarians and vegans, obtaining sufficient vitamin B12 can be challenging as it is primarily found in animal-based products. However, there are several strategies to maintain adequate B12 levels:
- Consume fortified plant-based milk alternatives and cereals
- Incorporate nutritional yeast into meals
- Consider taking a B12 supplement or multivitamin
- Opt for fortified meat substitutes
- Discuss B12 injections with a healthcare provider if necessary
Interactions Between Vitamin B12 and Medications
Certain medications can interfere with the absorption or effectiveness of vitamin B12. It’s essential to be aware of these interactions and consult with a healthcare provider if you’re taking any of the following medications:
- Colchicine
- Metformin
- Proton pump inhibitors
- Vitamin C supplements
- Chloramphenicol
- H2 blockers
- Aminosalicylic acid
Additionally, folic acid supplements may interfere with vitamin B12 absorption. If you need to take both supplements, it’s advisable to consume them at different times of the day to ensure optimal absorption.
How can you manage potential drug interactions with vitamin B12?
To minimize the risk of interactions between vitamin B12 and other medications, consider the following strategies:
- Inform your healthcare provider about all medications and supplements you’re taking
- Take vitamin B12 supplements at a different time than other medications
- Monitor your B12 levels regularly if you’re on long-term medication that may affect absorption
- Discuss alternative treatment options with your doctor if necessary
Special Considerations for Vitamin B12 Supplementation
While vitamin B12 supplements are generally safe for most people, there are some special considerations to keep in mind:
Is vitamin B12 supplementation safe during pregnancy and breastfeeding?
Vitamin B12 is considered safe to take in recommended dosages during pregnancy and breastfeeding. In fact, adequate B12 intake is crucial for fetal development and infant health. However, it’s essential to consult with a healthcare provider to determine the appropriate dosage based on individual needs.
Are there any contraindications for vitamin B12 supplementation?
Individuals with certain conditions or allergies should exercise caution when considering vitamin B12 supplements:
- Those with sensitivities or allergies to vitamin B12, cobalt, or other supplement ingredients
- People with Leber’s disease (a rare eye condition)
- Individuals with a history of certain blood disorders
Always consult with a healthcare provider before starting any new supplement regimen, especially if you have pre-existing medical conditions or are taking medications.
Monitoring and Managing Vitamin B12 Intake
Proper monitoring and management of vitamin B12 intake are essential for maintaining optimal health and avoiding potential side effects. Here are some key points to consider:
How often should you have your vitamin B12 levels checked?
The frequency of vitamin B12 level checks depends on individual risk factors and health status. Generally, it’s recommended to have B12 levels checked:
- Annually for individuals over 50 years old
- Every 2-3 years for vegetarians and vegans
- As advised by a healthcare provider for those with chronic conditions or taking medications that may affect B12 absorption
What should you do if you experience side effects from vitamin B12 supplements?
If you notice any adverse effects after starting vitamin B12 supplements, take the following steps:
- Discontinue use of the supplement immediately
- Monitor your symptoms closely
- Seek medical attention if symptoms persist or worsen
- Consult your healthcare provider to determine an appropriate dosage or alternative sources of vitamin B12
Remember that most side effects subside once supplementation is stopped. However, it’s crucial to work with a healthcare professional to ensure you’re meeting your vitamin B12 needs through diet or adjusted supplementation.
Can you reverse vitamin B12 deficiency through dietary changes alone?
In some cases, mild vitamin B12 deficiency can be addressed through dietary changes. However, severe deficiencies often require medical intervention, such as high-dose oral supplements or B12 injections. The ability to reverse deficiency through diet alone depends on factors such as:
- The severity of the deficiency
- The underlying cause (e.g., malabsorption issues, dietary restrictions)
- Individual health status and age
Working closely with a healthcare provider or registered dietitian can help determine the most appropriate approach for addressing vitamin B12 deficiency and maintaining optimal levels long-term.
Vitamin B-12 Side Effects
Vitamin B-12 Side Effects
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Medically reviewed by Jared Meacham, Ph. D., RD, PMP, MBA, CSCS — By Emily Cronkleton — Updated on June 8, 2023
Your doctor will give you the right dosage of vitamin B-12 supplement, especially if you will inject it. Taking too much can cause side effects like nausea, headache, dizziness, and in rarely, blood clots or cancer.
Everyone needs vitamin B-12, and most people get enough through their diet. However, it’s important to know what side effects occur when you take too much.
Vitamin B-12 is water-soluble and absorbed in the intestines. After it’s absorbed, it’s used to make DNA and red blood cells. Vitamin B-12 that isn’t being used is stored in the liver. But if you take supplements, you might ingest more than your body needs.
Oral vitamin B-12 is safe to take at recommended doses for healthy people.
Injectable vitamin B-12, which is used to treat significant deficiencies, can cause the following side effects:
- mild diarrhea
- itching
- skin rash
- headache
- dizziness
- nausea
- vomiting
- pulmonary edema and congestive heart failure early in treatment
- vein thrombosis
- sensation of swelling
- polycythemia vera (rare, slow growing blood cancer)
Vitamin B-12 can cause very rare but serious allergic reactions (anaphylaxis). This includes swelling of the face, tongue, and throat, and difficulty swallowing and breathing. If this occurs after you take vitamin B-12, call 911 or your local emergency services immediately.
Some agents are linked to reduced absorption or serum levels of vitamin B-12. You may need vitamin B-12 supplements if you take any of the following:
- colchicine
- metformin
- proton pump inhibitors
- vitamin C
- chloramphenicol
- h3 blockers
- aminosalicylic acid
Folic acid supplements may interfere with vitamin B-12. Be sure to tell your doctor if you take folic acid.
You may need to take vitamin B-12 separately from the above drugs and supplements — say, one in the morning and one at night — so you can get the full dose of vitamin B-12.
Don’t take vitamin B-12 supplements if you have sensitivities or allergies to vitamin B-12, cobalt, and any other ingredients. Vitamin B-12 is safe to take in recommended dosages if you’re pregnant or breastfeeding.
If you notice any adverse effects after you start taking vitamin B-12 supplements, you should discontinue use immediately. Seek medical attention if your symptoms get worse or are severe.
You can consult your doctor to establish an appropriate dose if it’s determined that you don’t get enough B-12 from food sources.
According to the National Institutes of Health, the recommended dietary amounts (RDAs) are as follows:
- 2.4 micrograms (mcg) daily for ages 14 years or older
- 2.6 mcg daily for pregnant women
- 2.8 mcg daily for breastfeeding women
If you’re over the age of 50, you should try to get your RDA by eating foods with B-12 or by taking a supplement containing 25 to 100 mcg of B-12.
Foods with vitamin B-12 include:
- eggs
- cheese
- fish
- shellfish
- liver
- kidney
- red meat
See your doctor if you have bothersome side effects that don’t go away once you stop taking the supplements. Avoid taking supplements if possible, and try to get B-12 from food sources.
If you develop any side effects from taking vitamin B-12, you can stop taking the supplement and the symptoms should subside.
After this, you’ll need to determine either an appropriate dose or how to get the vitamin B-12 you need from food sources. You can discuss this with your doctor.
Article resources
- Cyanocobalamin – cyanocobalamin injection. (2023). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a66eb3c4-3e1d-4d49-b963-4fa2334cc9b6
- Vitamin B12: Fact sheet for health professionals. (2022). https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/
Last medically reviewed on June 8, 2023
How we reviewed this article:
Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.
Current Version
Jun 8, 2023
Written By
Emily Cronkleton
Edited By
John Bassham
Medically Reviewed By
Jared Meacham, Ph. D., RD, PMP, MBA, CSCS
Copy Edited By
Copy Editors
Feb 15, 2023
Written By
Emily Cronkleton
Edited By
Frank Crooks
VIEW ALL HISTORY
Share this article
Medically reviewed by Jared Meacham, Ph.D., RD, PMP, MBA, CSCS — By Emily Cronkleton — Updated on June 8, 2023
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Vitamin B-12 Side Effects
Vitamin B-12 Side Effects
- Health Conditions
- Featured
- Breast Cancer
- IBD
- Migraine
- Multiple Sclerosis (MS)
- Rheumatoid Arthritis
- Type 2 Diabetes
- Articles
- Acid Reflux
- ADHD
- Allergies
- Alzheimer’s & Dementia
- Bipolar Disorder
- Cancer
- Crohn’s Disease
- Chronic Pain
- Cold & Flu
- COPD
- Depression
- Fibromyalgia
- Heart Disease
- High Cholesterol
- HIV
- Hypertension
- IPF
- Osteoarthritis
- Psoriasis
- Skin Disorders and Care
- STDs
- Featured
- Discover
- Wellness Topics
- Nutrition
- Fitness
- Skin Care
- Sexual Health
- Women’s Health
- Mental Well-Being
- Sleep
- Product Reviews
- Vitamins & Supplements
- Sleep
- Mental Health
- Nutrition
- At-Home Testing
- CBD
- Men’s Health
- Original Series
- Fresh Food Fast
- Diagnosis Diaries
- You’re Not Alone
- Present Tense
- Video Series
- Youth in Focus
- Healthy Harvest
- No More Silence
- Future of Health
- Wellness Topics
- Plan
- Health Challenges
- Mindful Eating
- Sugar Savvy
- Move Your Body
- Gut Health
- Mood Foods
- Align Your Spine
- Find Care
- Primary Care
- Mental Health
- OB-GYN
- Dermatologists
- Neurologists
- Cardiologists
- Orthopedists
- Lifestyle Quizzes
- Weight Management
- Am I Depressed? A Quiz for Teens
- Are You a Workaholic?
- How Well Do You Sleep?
- Tools & Resources
- Health News
- Find a Diet
- Find Healthy Snacks
- Drugs A-Z
- Health A-Z
- Health Challenges
- Connect
- Breast Cancer
- Inflammatory Bowel Disease
- Psoriatic Arthritis
- Migraine
- Multiple Sclerosis
- Psoriasis
Medically reviewed by Jared Meacham, Ph. D., RD, PMP, MBA, CSCS — By Emily Cronkleton — Updated on June 8, 2023
Your doctor will give you the right dosage of vitamin B-12 supplement, especially if you will inject it. Taking too much can cause side effects like nausea, headache, dizziness, and in rarely, blood clots or cancer.
Everyone needs vitamin B-12, and most people get enough through their diet. However, it’s important to know what side effects occur when you take too much.
Vitamin B-12 is water-soluble and absorbed in the intestines. After it’s absorbed, it’s used to make DNA and red blood cells. Vitamin B-12 that isn’t being used is stored in the liver. But if you take supplements, you might ingest more than your body needs.
Oral vitamin B-12 is safe to take at recommended doses for healthy people.
Injectable vitamin B-12, which is used to treat significant deficiencies, can cause the following side effects:
- mild diarrhea
- itching
- skin rash
- headache
- dizziness
- nausea
- vomiting
- pulmonary edema and congestive heart failure early in treatment
- vein thrombosis
- sensation of swelling
- polycythemia vera (rare, slow growing blood cancer)
Vitamin B-12 can cause very rare but serious allergic reactions (anaphylaxis). This includes swelling of the face, tongue, and throat, and difficulty swallowing and breathing. If this occurs after you take vitamin B-12, call 911 or your local emergency services immediately.
Some agents are linked to reduced absorption or serum levels of vitamin B-12. You may need vitamin B-12 supplements if you take any of the following:
- colchicine
- metformin
- proton pump inhibitors
- vitamin C
- chloramphenicol
- h3 blockers
- aminosalicylic acid
Folic acid supplements may interfere with vitamin B-12. Be sure to tell your doctor if you take folic acid.
You may need to take vitamin B-12 separately from the above drugs and supplements — say, one in the morning and one at night — so you can get the full dose of vitamin B-12.
Don’t take vitamin B-12 supplements if you have sensitivities or allergies to vitamin B-12, cobalt, and any other ingredients. Vitamin B-12 is safe to take in recommended dosages if you’re pregnant or breastfeeding.
If you notice any adverse effects after you start taking vitamin B-12 supplements, you should discontinue use immediately. Seek medical attention if your symptoms get worse or are severe.
You can consult your doctor to establish an appropriate dose if it’s determined that you don’t get enough B-12 from food sources.
According to the National Institutes of Health, the recommended dietary amounts (RDAs) are as follows:
- 2.4 micrograms (mcg) daily for ages 14 years or older
- 2.6 mcg daily for pregnant women
- 2.8 mcg daily for breastfeeding women
If you’re over the age of 50, you should try to get your RDA by eating foods with B-12 or by taking a supplement containing 25 to 100 mcg of B-12.
Foods with vitamin B-12 include:
- eggs
- cheese
- fish
- shellfish
- liver
- kidney
- red meat
See your doctor if you have bothersome side effects that don’t go away once you stop taking the supplements. Avoid taking supplements if possible, and try to get B-12 from food sources.
If you develop any side effects from taking vitamin B-12, you can stop taking the supplement and the symptoms should subside.
After this, you’ll need to determine either an appropriate dose or how to get the vitamin B-12 you need from food sources. You can discuss this with your doctor.
Article resources
- Cyanocobalamin – cyanocobalamin injection. (2023). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a66eb3c4-3e1d-4d49-b963-4fa2334cc9b6
- Vitamin B12: Fact sheet for health professionals. (2022). https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/
Last medically reviewed on June 8, 2023
How we reviewed this article:
Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.
Current Version
Jun 8, 2023
Written By
Emily Cronkleton
Edited By
John Bassham
Medically Reviewed By
Jared Meacham, Ph. D., RD, PMP, MBA, CSCS
Copy Edited By
Copy Editors
Feb 15, 2023
Written By
Emily Cronkleton
Edited By
Frank Crooks
VIEW ALL HISTORY
Share this article
Medically reviewed by Jared Meacham, Ph.D., RD, PMP, MBA, CSCS — By Emily Cronkleton — Updated on June 8, 2023
Read this next
- Vitamin B12 Deficiency and Weight Gain — What to Know
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Vitamin B12 deficiency can cause various symptoms, and you may wonder whether weight gain is among them. This article reviews whether a vitamin B12…
READ MORE
- What Is a Vitamin B-12 Test?
Medically reviewed by Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT
A vitamin B-12 test measures the amount of B-12 in your blood. Find out what your B-12 results mean and how to optimize your B-12 intake.
READ MORE
- Vitamin B12 (folate deficiency anemia) Signs and Symptoms
By Jillian Kubala, MS, RD
Vitamin B12 is an important water-soluble vitamin that many people are deficient in. Here are nine signs and symptoms of vitamin B12 deficiency.
READ MORE
- Vitamin B12 Dosage: How Much Should You Take per Day?
By Melissa Groves
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By Keith Pearson, PhD, RD
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READ MORE
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Cyanocobalamin (Vitamin B12) – instructions for use, doses, side effects, reviews of the drug:
Description of the drug in 1998
Date of approval: 07/31/1998
Content
- Active substance
- ATX
- Pharmacological group
- Nosological classification (ICD-10)
- Composition and form of release
- pharmachologic effect
- pharmachologic effect
- Indications
- Contraindications
- Dosage and administration
- Side effects
- Interaction
- Precautionary measures
- Storage conditions
- Best before date
- Reviews
Active ingredient
Cyanocobalamin* (Cyanocobalamin*)
ATX
B03BA01 Cyanocobalamin
Pharmacological group
Stimulants of hematopoiesis
Vitamins and vitamin-like products
Nosological classification (ICD-10)
ICD-10 code list
Composition and formulation
1 ml solution for injection contains cyanocobalamin (vitamin B 12 ) 200 or 500 mcg; in ampoules of 1 ml, in a cardboard box 10 pcs.
Pharmacological action
Pharmacological action –
hematopoietic , stimulating cell metabolism .
Participates in the transfer of methyl fragments, the formation of choline, methionine, creatine, nucleic acids, the maturation of erythrocytes, promotes the accumulation of compounds containing sulfhydryl groups in erythrocytes.
Participates in the transfer of methyl fragments, the formation of choline, methionine, creatine, nucleic acids, the maturation of erythrocytes, promotes the accumulation of compounds containing sulfhydryl groups in erythrocytes.
Indications
Anemia (Addison-Birmer, alimentary macrocytic, iron deficiency,
posthemorrhagic, aplastic, caused by toxic substances and drugs), cirrhosis of the liver,
hepatitis, myelosis, polyneuritis, sciatica, trigeminal neuralgia, amyotrophic lateral sclerosis, children
cerebral palsy, multiple sclerosis, Down’s disease, skin diseases, peripheral nerve injuries.
Contraindications
Thromboembolism, angina.
Dosage and administration
Information for healthcare professionals only.
Are you a healthcare professional?
S/C, IM, IV and intralumbar.
Addison-Birmer anemia – 100-200 mcg every other day; with Addison-Birmer anemia with symptoms of funicular myelosis and with macrocytic anemia with disorders of the nervous system – 500 mcg or more per injection (daily for the first week, and then with intervals between injections of up to 5-7 days). Simultaneously appoint folic acid. In the period of remission, in the absence of funicular myelosis phenomena, 100 mcg is administered for maintenance therapy 2 times a month, and in the presence of neurological phenomena, 200-400 mcg 2-4 times a month.
For iron deficiency and posthemorrhagic anemia – 30-100 mcg 2-3 times a week; with aplastic anemia (especially in children) – 100 mcg until the onset of clinical and hematological improvement; with alimentary anemia in children at an early age and in premature babies – 30 mcg / day for 15 days.
In diseases of the central nervous system and neurological diseases with pain syndrome, it is administered in increasing doses from 200 to 500 mcg per injection, and when the condition improves, 100 mcg/day; course – up to 2 weeks.
In traumatic lesions of the peripheral nerves – 200-400 mcg every other day for 40-45 days.
For hepatitis and liver cirrhosis, 30–60 mcg per day or 100 mcg every other day for 25–40 days.
With dystrophies in young children, Down’s disease and cerebral palsy – 15-30 mcg every other day.
In case of funicular myelosis, amyotrophic lateral sclerosis, multiple sclerosis, sometimes 15-30 mcg is injected into the spinal canal (gradually increasing the dose to 200-250 mcg).
Side effects
Excitation, pain in the heart, tachycardia, allergic reactions.
Interactions
Information for healthcare professionals only.
Are you a healthcare professional?
Incompatible (in one syringe) with thiamine bromide, riboflavin.
Precautions
In angina pectoris, use with caution and in lower doses.
Storage conditions
In a place protected from light.
Keep out of reach of children.
Expiry date
2 years.
Do not use after the expiry date which is stated on the packaging.
Update date: 04/30/2020
Vitamin B12 – instructions for use, doses, side effects, reviews of the drug: instant tablets, 5000 mcg
0.004 ‰
Analogs
Description selection
Lec. form | Dosage |
---|---|
instant tablets | 5000 mcg |
injection | 0. 2 mg/ml |
instant tablets
5000 mcg
injection
0.2 mg/ml
All forms of release, dosages, registration certificates, drug manufacturers, drug characteristics
Product description Vitamin B12 (solution for injection, 0.2 mg/ml) based on the official instructions, approved by the manufacturer in 1998
Date approved: 07/31/1998
Contents
- Active substance
- ATX
- Pharmacological group
- Composition and form of release
- Dosage and administration
- Storage conditions
- Best before date
- Reviews
Active ingredient
Cyanocobalamin* (Cyanocobalamin*)
ATX
B03BA01 Cyanocobalamin
Pharmacological group
Stimulants of hematopoiesis
Vitamins and vitamin-like products
Composition and form of release
1 ampoule with 1 ml solution for injection contains cyanocobalamin 200 or 500 mcg; in a box of 10 pcs. , complete with an ampoule knife.
Dosage and administration
Information for healthcare professionals only.
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S/C, IM, IV and intralumbar. For Addison-Birmer anemia (in combination with folic acid)
– 100-200 mcg once a day, for 2 days; with Addison-Birmer anemia with symptoms
funicular myelosis and macrocytic anemia with disorders of the nervous system – 500 mcg and
more per injection (in the first week daily, and then at intervals between injections up to 5-7 days). During
remissions – 100 mcg 2 times a month (maintenance therapy), in the presence of neurological phenomena
(funicular myelosis) – 200-400 mcg 2-4 times a month. With iron deficiency and
posthemorrhagic anemia – 30-100 mcg 2-3 times a week; with aplastic anemia
(especially in children) – 100 mcg until the onset of clinical and hematological improvement; with alimentary
anemia in children at an early age and in premature babies – 30 mcg / day for 15 days.