Vitamin B12 - what the body needs, forms of release, names of drugs and how to take it for women, men and children. Complexes in tablets and injections. Vitamin B12 tablets - when is the drug prescribed? Features of admission and contraindications

Registration number: LS-000095-260110

Trade name of the drug: cyanocobalamin

International nonproprietary name (INN): cyanocobalamin

chemical name: alpha-(5,6-dimethylbenzimidazolyl)cobamide

Dosage form: injection

Description: Light pink to bright red clear liquid.

Compound:
For 1 ml:
Active substance: 1 ml contains
Cyanocobalamin -200 or 500 mcg
Excipients: water for injection, sodium chloride.

Pharmacotherapeutic group: vitamin
ATX code B03BA01

Pharmacological properties
Pharmacodynamics
Vitamin B 12 has a metabolic and hematopoietic effect. In the body (mainly in the liver) it turns into a coenzyme form - adenosylcobalamin, or cobamamide, which is the active form of vitamin B 12 and is part of numerous enzymes, incl. into the reductase, which reduces folic acid to tetrahydrofolic acid. Possesses high biological activity.
Cobamamide is involved in the transfer of methyl and other single-carbon fragments, therefore it is necessary for the formation of deoxyribose and DNA, creatine, methionine - a donor of methyl groups, in the synthesis of the lipotropic factor - choline, for the conversion of methylmalonic acid and succinic acid, which is part of myelin, for the utilization of propionic acids. Necessary for normal hematopoiesis - promotes the maturation of red blood cells.
It promotes the accumulation of compounds containing sulfhydryl groups in erythrocytes, which increases their tolerance to hemolysis. It activates the blood coagulation system, in high doses it causes an increase in thromboplastic activity and prothrombin activity. Reduces the level of cholesterol in the blood. It has a beneficial effect on the function of the liver and nervous system. Increases the ability of tissues to regenerate.
Daily requirement for vitamin B 12: for adult men - 1-2 mg; for the elderly -1.2-1.4 mg; for women - 1-2 mg (in pregnant women more by 0.5 mg, in lactating women - by 0.6 mg); for children, depending on age - 0.3-1.4 mg.

Pharmacokinetics
In the blood, vitamin B 12 binds to transcobalamins I and II, which transport it to tissues. It is deposited mainly in the liver.
Communication with plasma proteins - 90%. The maximum concentration after subcutaneous and intramuscular administration is after 1 hour.
It is excreted from the liver with bile into the intestines and reabsorbed into the blood. The half-life is 500 days. It is excreted with normal kidney function - 7-10% by the kidneys, about 50% - with feces; with reduced kidney function - 0-7% by the kidneys, 70-100% - with feces. Penetrates through the placental barrier, breast milk.

Indications for use
Conditions accompanied by a deficiency of vitamin B 12:
Chronic anemia occurring with a deficiency of vitamin B 12 (Addison-Birmer's disease, alimentary macrocytic anemia), as part of the complex therapy of anemia (including iron deficiency, posthemorrhagic, aplastic, anemia caused by toxic substances and / or JIC).
In complex therapy:
Chronic hepatitis, liver cirrhosis, liver failure, alcoholism.
In neurology: polyneuritis, radiculitis, malnutrition, neuralgia (including trigeminal neuralgia), funicular myelosis, peripheral nervous system diseases:; systems of traumatic genesis, amyotrophic lateral sclerosis, cerebral palsy, Down's disease.
In dermatology Key words: psoriasis, photodermatosis, dermatitis herpetiformis, atopic dermatitis.
With a preventive purpose- when prescribing biguanides, PASK, ascorbic acid in high doses, pathology of the stomach and intestines with malabsorption of vitamin B 12 (resection of part of the stomach, small intestine, Crohn's disease, malabsorption syndrome, sprue), enteritis, diarrhea, radiation sickness.

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.

Carefully
Angina pectoris, benign and malignant neoplasms, accompanied by megaloblastic anemia and vitamin B 12 deficiency, a tendency to form blood clots.

Dosage and administration
The drug is used subcutaneously, intramuscularly, intravenously and intralumbally.
Subcutaneously, with Addison-Birmer anemia - 100-200 mcg / day every other day; with funicular myelosis, macrocytic anemia with dysfunction of the nervous system - 400-500 mcg / day in the first week - daily, then at intervals between injections of up to 5-7 days (folic acid is prescribed simultaneously); during the period of remission, the maintenance dose is -100 mcg / day 2 times a month, and in case of impaired function of the nervous system, 200-400 mcg 2-4 times a month.
In acute posthemorrhagic and iron deficiency anemia - 30-100 mcg 2-3 times a week; with aplastic anemia - 100 mcg until the onset of clinical and hematological improvement. For disorders of the nervous system - 200-400 mcg 2-4 times a month.
In diseases of the central nervous system and peripheral nervous system - 200-500 mcg every other day for 2 weeks.
In diseases of the peripheral nervous system of traumatic origin - 200-400 mcg every other day for 40-45 days.
With hepatitis and cirrhosis of the liver - 30-60 mcg / day or 100 mcg every other day for 25-40 days.
With radiation sickness - 60-100 mcg daily for 20-30 days. With funicular myelosis, amyotrophic lateral sclerosis - intralumbally, 15-30 mcg with a gradual increase in dose to 200-250 mcg per injection.
To eliminate vitamin B12 deficiency, it is administered intramuscularly or intravenously, 1 mg daily for 1-2 weeks.
Young children with alimentary anemia and premature babies - subcutaneously 30 mcg per day daily for 15 days. With dystrophies in young children, Down's disease and cerebral palsy - subcutaneously, 15-30 mcg every other day.

Side effect
Allergic reactions, mental agitation, cardialgia, tachycardia, diarrhea, headache, dizziness. When used in high doses - hypercoagulability, impaired purine metabolism.

Interaction with other drugs
Pharmaceutically incompatible with ascorbic acid, salts of heavy metals (inactivation of cyanocobalamin), thiamine bromide, pyridoxine, riboflavin (since the cobalt ion contained in the cyanocobalamin molecule destroys other vitamins). Do not combine with drugs that increase blood clotting. Aminoglycosides, salicylates, antiepileptic drugs, colchicine, potassium preparations reduce absorption.
Increases the risk of developing allergic reactions caused by thiamine.
Chloramphenicol reduces the hematopoietic response.
Enhances the toxic effect in combination with folic acid.

Special instructions
Vitamin B12 deficiency should be confirmed diagnostically before prescribing the drug, as it may mask a lack of folic acid. During the period of treatment, it is necessary to monitor peripheral blood parameters: on the 5-8th day of treatment, the content of reticulocytes, the concentration of iron is determined. The number of erythrocytes, Hb and color indicator must be monitored for 1 month 1-2 times a week, and then 2-4 times a month. Remission is achieved with an increase in the number of erythrocytes to 4-4.5 million / μl, with the achievement of normal sizes of erythrocytes, the disappearance of aniso- and poikilocytosis, and the normalization of the content of reticulocytes after a reticulocyte crisis. After achieving hematological remission, peripheral blood control is carried out at least once every 4-6 months.
Exercise caution in persons prone to thrombosis, angina pectoris (in smaller doses up to 0.1 mg per injection). Take a long time with pernicious anemia, upcoming operations on the gastrointestinal tract. When taking the recommended doses during pregnancy, lactation, as well as in the elderly, no adverse reactions other than those listed above were noted.

Release form
1 ml in ampoules. 10 ampoules in a carton pack with a knife for opening ampoules or an ampoule scarifier.

Best before date
2 years.
Do not use after the expiry date stated on the packaging.

Storage conditions
In a place protected from light, out of the reach of children.
At a temperature not higher than 25°C.

Terms of dispensing from pharmacies
On prescription.

Manufacturer
OJSC "Yerevan chemical-pharmaceutical firm"
Russia 375040, Armenia, Yerevan, st. Adzharyan 2nd Lane, No. 6.

Claims address:
StatusFarm LLC
Russia 109316, Moscow, Ostapovsky pr-d, 5, building 1

As I already wrote, both of us had it very low. Nevertheless, with such a low b12 (only 43), I consistently felt wonderful, but Serezha had fluctuations in well-being from super cool to shit (). After receiving the results of the tests, Serezha was sure that the reason was his low B12, so he decided to start taking it. And I wanted to take B12 to get rid of cellulite (the experience of russula shows that it really works, and how !!). We ordered b12 tablets - recommended to us by our friends Yulia and Paul, who have been on a raw food diet since 2009, just like me, and they are well versed in health issues, give advice, shoot videos, maintain a website. So, these are Jarrow Methylcobalamin B12 tablets, 1000mcg ($6.29 for 100 tablets). Those. methyl (methylcobalamin) b12 from Jarrow 1000 mcg per tablet. We ordered them from America, because. they are not sold in Russia, and it was necessary to wait for delivery for 3 whole weeks.

While we were waiting for our b12 tablets, we decided to start a course of injections. It turned out that almost every pharmacy sells b12 ampoules, but this is not methylcobalamin, but cyanocobalamin. 10 ampoules = 40 rubles; 10 syringes = 50 rubles. Ooooh, how scary it was to give an injection for the first time! Yes, and the next time is also a little points. From fear, every time before the injection, I wanted to go big in tubes: D That's honest!: D Some injections turned out to be barely sick, one was generally painless, I even wanted to ask Serezha why he didn’t give me an injection, and a couple of patients. We gave injections not in the thigh, as they recommend everywhere, but in the pope, because. it’s somehow more familiar or something))) In childhood, I think, almost everyone was given injections in the ass)))
Here is what is included in the composition of cyanocobalamin: cyanocobalamin 500 mg, sodium chloride 9g. In one ampoule 1 ml of liquid, of which 0.5 mg of cyanocobalamin itself - please do not confuse.
The first 2 injections went well, but right after the 3rd one, I felt like going to practice. Mind ward, it’s called ... My heart stabbed: (And it was beating furiously! For about an hour there was some kind of tachycardia, if I call it correctly - the heart was beating unstable, and this caused discomfort. Although they don’t write anywhere on the Internet and nowhere at all that immediately after b12 injections you can’t engage in high-intensity training. I slept badly that night, because my heart was beating strongly .. In the morning, it was like shortness of breath. And all the next day, the heart muscle ached - in the center, as if a little to the right and a little to the left of the very center .. it hurt to wipe off the table, open the drawer, move the laptop, open the pump for watering, tear off a twig from a tomato, wash my hands, hug Serezha. The next day I slept well, and in general it became normal, but this central muscle still ached a little.I climbed into the Internet and subtracted about the following side effects from b12 injections: 1) A rapid heartbeat - rapid heartbeat; Heart palpitations - arrhythmia; Chest pain - chest pain; A feeling of tightness in the chest - a feeling of heaviness in the chest; Difficulty breathing - breathing problems; Shortness of breath with mild exertion or when lying down - shortness of breath. In general, I gave the next injection only after 2 days.
In general, b12 injections are recommended to be given as follows:
- With super-low b12 like mine: the first week every day, the second week every other day, the 3rd week after two days, the 4th week once a week, and then every 3 months to maintain the level of b12.
- If the level is not so low, but for example 100-200, then the injection scheme is as follows: every day for a week, then one injection per week for a month, and then every month, and then every 3 months to maintain.
In general, then my heart revived, I relaxed, so to speak, and again, almost immediately after the injection, I began to play sports, but in a different way - push-ups, lunges, squats, etc. And even so - at first she made an injection, then immediately ate a super-satisfactory meal and immediately began to do upright. My heart a little pricked, but in the morning I grabbed it specifically ((Very prickly ((Like in childhood ... I used to have such nonsense, I didn’t even go to the gym, the doctors said it was vegetative-vascular dystonia.
So in total I gave 9 injections of cyano-b12. The last injection was June 6th. And on June 11, she again passed the analysis, in the same laboratory, for reliability. B12 went up from 43 to 645. And Serezha's from 46 to 497, although he gave 12 injections, i.e. three more than me. It is strange that I have more of it, because there were fewer injections!!

And recently our methyl-b12 pills from Jarrow came. If in each injection we received 500 mg of b12 (as it is written on the package, although probably still 500 mcg), then with these tablets 1000 mcg. We have been taking these pills since June 11th. Those. first they passed a second analysis, and then they began to drink b12 tablets. We took the first pills at 8 o'clock in the evening, and both could not fall asleep for a long time, they lay half asleep, it felt like they had run 10 km !! The next time there was no such thing, but now I noticed such a chip in myself that if I overeat, my heart starts to tingle .. not hellishly, but tensely. Especially if you eat dish mania from the heart in the evening and go to bed with a slightly full stomach .. Looks like the stomach presses on the heart, so discomfort. I remember that even before taking b12, I once had a strong heart attack when we were on the island this winter. Then I cracked up in the market of all sorts of fruits, and kaaaak grabbed my heart ... Plus, then I was hellishly sleepy for 4-5 days ... Then I slept off and after 2 days the pain in my heart disappeared. After that, I stuffed a full belly a hundred times, there was nothing. And then after b12 again: (There is only one conclusion - do not overeat!)))) There are small portions, but more often. Although I, of course, have recently become accustomed to eating 3 times a day, but in large volumes.

And a little more about methyl-b12. Everywhere it is said that it is better than cyano. That, for example, in women's milk b12 is contained precisely in the form of methylcobalamin, and in human blood plasma too.
By the way, since the level of b12 has already risen to the desired level, then the maintenance dose of methyl b12 tablets is now 2000 mcg per week. Those. 2 tablets of 1000 mcg per week. Since I drank today on Monday, then the next time on Thursday. I will drink them on Mondays and Thursdays. Well, after a while, it will again be necessary to do an analysis to check.

I also read that methyl-b12 is excreted in bile in an amount of 0.5 to 8 mcg per day.
Among the side effects of Jarrow's methylcobalamin is: "sometimes there may be nausea, vomiting, diarrhea, headache, dizziness, tachycardia, agitation." And in cyano-b12 times 10 more side effects, and I indicated above only those that manifested themselves in me.

Here is the composition of Jarrow methylcobalamin:
“xylitol (xylitol), cellulose (cellulose, fiber), stearic acid (vegetable source), natural flavor (natural flavor), magnesium stearate (vegetable source) (magnesium stearate (vegetable source) ), citric acid (citric acid) and silicon dioxide (silicon dioxide).
No wheat, no gluten, no soybeans, no diary, no egg, no fish/shellfish, no peanuts/tree nuts.“
There is nothing particularly harmful))) Xylitol is a natural sugar. For example, from birch wood, etc.

I also read that methyl-b12 is much better absorbed by the body than cyano-b12. Only methylcobalamin tablets should not be swallowed, chewed or dissolved, but simply put under the tongue and do nothing. After 25-30 minutes, the tablet will dissolve itself. Thus, b12 does not enter the stomach, but immediately into the blood, that is, the effect is approximately the same as from injections.

Today, after receiving the analysis, it became psychologically easier for me because I no longer have a B12 deficiency))) Well, cellulite will disappear)))) They say that the first effect is noticeable a month after taking b12, but I already see it now;) Although I started taking b12 only on May 23, so even a month has not passed yet. Clarification - after a month, people usually notice that cellulite becomes a little less, and after a few more months it completely disappears.
So, psychologically, it became easier for me, although there are no changes in my state of health, well, there are no at all - both at the level of 43, which is 645. The same! And Serezha has the same nonsense - all the same mood swings and well-being ... And after the first 4-5 commercials injections, he was just mega-cool, he says that the pin was like from drugs, but then the swing started again: (What's the matter, it’s not clear ... Even on vegetarianism with milk and fish, this began. If anyone is in the subject, why there may be jumps in mood and well-being, please let me know)))

Now look at where and how Frehley gives himself a B12 injection (starting at 12:30 minutes):

Vitamin B12 (Cobalamin, cyanocobalamin) - physiological role, signs of deficiency, content in food. Instructions for the use of vitamin B12

Thanks

Vitamin B 12 is a compound that has a very important ability to regulate hematopoiesis, ensuring the formation of normal-shaped erythrocytes with full functions. That is why vitamin B 12 is often referred to as anti-anemic factor .

Name and forms of vitamin B 12

In addition, there are two more active forms of vitamin B12 ( methylcobalamin and deoxyadenosylcobalamin ), which are formed from cyanocobalamin and hydroxycobalamin in the human body. It is in active forms that vitamin B 12 performs its physiological functions. The names of the active forms are practically not used to refer to vitamin B 12 .

What is vitamin B 12 for - physiological role

The listed physiological effects are provided at the molecular level, at which vitamin B 12 activates and maintains certain biochemical transformations. At first glance, it is difficult to imagine, but in fact, every biochemical transformation in the body that occurs at the molecular level has its own "physiological" reflection in the form of an effect at the level of organs and tissues. Consider how vitamin B 12 provides its physiological effects at the molecular level.

Active forms of vitamin B 12 ensure the normal functioning of enzymes from the reductase class, which, in turn, convert folic acid to tetrahydrofolic acid. And tetrahydrofolic acid activates the process of cell division and, therefore, ensures the normal process of regeneration of organs and tissues, keeping them young and fully functioning. The activation of cell division is especially important for rapidly renewing tissues, such as blood cells, mucous membranes, epidermis, etc. It is thanks to the influence of vitamin B 12 that these tissues are maintained in a normal state.

In addition, the ability of cobalamin to activate cell division is able to prevent megaloblastic anemia. The fact is that with a deficiency of vitamin B 12, erythrocyte precursor cells grow, but do not divide, as a result of which giant erythrocytes (megaloblasts) are formed in a small amount. Such red blood cells contain little hemoglobin and cannot penetrate into small vessels due to their size, resulting in megaloblastic anemia. Vitamin B 12 stimulates the timely division of progenitor cells, resulting in the formation of a large number of normal red blood cells containing hemoglobin in sufficient concentration.

The formation of a myelin sheath on nerve fibers is impossible without a sufficient amount of vitamin B 12, since its active form ensures the conversion of methylmalonic acid into succinic acid, which is an essential structural component of myelin. If vitamin B 12 is not enough, then succinic acid is not formed in the required amount, as a result of which the nerve fiber remains demyelinated. The lack of myelin leads to impaired sensitivity, poor conduction of impulses from the brain to the muscles and vice versa, resulting in numbness of the limbs, tingling, tingling, and other symptoms of nerve fiber degeneration.

Prevention of fatty degeneration of various organs is ensured by the ability of vitamin B 12 to activate the conversion of homocysteine ​​to methionine. Methionine, in turn, is necessary for the process of removing excess fat by the liver.

Absorption and excretion of vitamin B 12

In general, the absorption of cobalamin into the blood from food is carried out in the following successive stages:
1. Formation of the Castle factor + cobalamin complex;
2. The entry of the complex into the small intestine and its passage through the wall into the portal vein of the liver;
3. The disintegration of the complex and the release of vitamin B 12;
4. Transfer of free vitamin B 12 to all organs.

In the cells of the organs, vitamin B 12 is converted into active forms - methylcobalamin and deoxyadenosylcobalamin, in which it exerts its physiological effects. After performing the functions, the active forms of vitamin B 12 are again transferred to the blood and delivered to the liver and kidneys, from where they are excreted with urine and feces.

In the liver, vitamin B 12 can accumulate, creating a depot, which is enough for a person for about 3 to 4 years.

Vitamin B 12 deficiency - symptoms

• Megaloblastic anemia;
• Increased fatigue;
• Funicular myelosis (degeneration of sections of the spinal cord);
• Paresthesia (feeling of running "goosebumps", tingling on the skin, etc.);
• Paralysisaccompanied by dysfunction of the pelvic organs;
• Dry tongue, colored bright red, on the surface of which tingling and burning can be felt;
• Decreased or complete lack of appetite;
• Unpleasant body odor;
• Achilia (zero acidity of gastric juice);
• Erosions and ulcers on the mucous membranes of various organs (mouth, throat, nose, bronchi, intestines, vagina, etc.);
• Heaviness when walking;
• yellowing of the skin;
• Shortness of breath and erratic heart rate during exercise;
• Focal hair loss;
• Ulceration of the corners of the mouth;
• Glossitis (inflammation of the tongue);
• Seborrheic dermatitis in certain areas of the skin of the body and face, especially near the nose or mouth;
• Inflammation and itching of the skin in the genital area in men and women;
• redness, itching, burning, and sensitivity of the eyes to light;
• Blurred vision;
• Formation of a cataract;
• Personal degradation.

Vitamin B 12 deficiency: causes, symptoms, consequences - video

Vitamin B 12 - what foods contain

• Beef liver (60 mcg of vitamin B 12 per 100 g of product);
• Pork liver (30 mcg per 100 g);
• Beef kidneys (25 mcg);
• Octopus (20 mcg);
• Chicken liver (16 mcg);
• Mackerel (12 mcg);
• Mussels (12 mcg);
• Sardine (11 mcg);
• Atlantic herring (10 mcg);
• Keta (4.1 mcg);
• Beef (3 mcg);
• Notothenia (2.8 mcg);
• Sea bass (2.4 mcg);
• Lamb (2 - 3 mcg);
• Egg (1.95 mcg);
• Turkey fillet (1.6 mcg);
• Cod (1.6 mcg);
• Carp (1.5 mcg);
• Curd (1.32 mcg);
• Shrimp (1.1 mcg);
• Cheeses (1.05 - 2.2 mcg);
• Broiler chickens (0.2 - 0.7 mcg);
• Milk and sour cream (0.4 mcg);
• Yogurt (0.4 - 0.7 mcg).

Foods rich in vitamin B 12 - video

Vitamin B 12 - the rate of consumption by people of different ages

These norms are called adequate intake levels, which provide full coverage of the body's needs for vitamin B 12 compounds. However, these adequate levels of consumption are valid only for a healthy person living a measured and calm life. With physical exertion, stress, emotional stress, smoking or drinking alcohol, the need for vitamin B 12 increases by 10 - 25%, which should be taken into account when planning your own diet.

The minimum safe intake of vitamin B 12 in a diet is 1 mcg per day. The maximum amount of vitamin B 12 that can be consumed without any harm to health is 9 mcg per day.

Vitamin B 12 in the blood - the norm

• Newborns from 0 to a year - 118 - 959 pmol / l;
• Children over one year old and adults under 60 years old - 148 - 616 pmol / l;
• Adults over 60 years old - 81 - 568 pmol / l.

In order to obtain the correct results of the study, which can be compared with the indicated normal indicators, it is necessary to cancel the drugs that affect the content of cyanocobalamin in the blood before taking the analysis, and also not to drink alcohol, fatty and fried foods. The result of the analysis may be underestimated if, in the days before blood donation, the person used the following drugs or underwent procedures:

• Alcohol;
• Aminoglycoside antibiotics (for example, chloramphenicol, etc.);
• Aminosalicylic acid;
• Colchicine;
• Oral contraceptives;
• pentamidine;
• Pyrimethamine;
• Anticonvulsants (for example, phenobarbital, phenytoin, etc.);
• Triamterene;
• Phenformin;
• Cholestyramine;
• Cimetidine;
• Irradiation of the small intestine with cobalt.

What are the B 12 vitamins for medical use

• cyanocobalamin;
• Hydroxocobalamin;
• Cobamamide.

Cyanocobalamin preparations have the weakest and slowest therapeutic effect. Hydroxocobalamin begins to have a therapeutic effect faster than cyanocobalamin, it remains in the blood longer and is more slowly excreted by the kidneys from the body. Thus, the duration of action of hydroxocobalamin also exceeds that of cyanocobalamin, so it can be administered less frequently, reducing the number of injections required for a full course of treatment.

Cobamamide has an almost instantaneous therapeutic effect, beginning to exert its physiological effects immediately after administration. In terms of the speed of development of the effect, cobamamide is the best option for vitamin B 12. Therefore, if you need to get a quick effect, for example, in severe and urgent conditions, it is necessary to use preparations containing vitamin B 12 in the form of cobamamide. In terms of other properties, cobamamide is comparable to hydroxocobalamin.

Vitamin B 12 with cobamamide and cyanocobalamin is available as a lyophilized powder, ready-to-use solution and tablets. And vitamin B 12 in the form of hydroxocobalamin is available only in the form of a sterile solution ready for use.

Vitamin B 12 in ampoules - characteristics and names of drugs

The lyophilisate is preferable to the ready-made solution, since in this form, during long-term storage, the properties of vitamin B 12 are better preserved.

In addition to dosage forms, vitamin B 12 in ampoules is available in three chemical varieties (cyanocobalamin, hydroxocobalamin and cobamamide) under the following commercial names:

• Cobamamide lyophilizate (cobamamide) - ampoules containing 0.1 mg, 0.5 mg and 1 mg of the active substance;
• Oxycobalamin solution (hydroxocobalamin) - ampoules containing the active substance in dosages of 50 μg / ml, 0.1 mg / ml and 1 mg / ml;
• Cyanocobalamin solution and lyophilisate (cyanocobalamin) - ampoules containing 30 µg/ml, 50 µg/ml, 100 µg/ml, 200 µg/ml and 500 µg/ml of the active substance;
• Cyanocobalamin bufus (cyanocobalamin) solution - ampoules containing 500 μg / ml of the active substance;
• Cyanocobalamin-Vial (cyanocobalamin) solution - ampoules containing 200 μg / ml and 500 μg / ml of the active substance.

Vitamin B 12 tablets - characteristics and names of drugs

Cobamamide tablets are available in three dosages - 0.1 mg, 0.5 mg and 1 mg. And Cyanocobalamin tablets contain 30 mcg, 50 mcg and 100 mcg of the active substance. Vitamin B 12 in tablet form is well absorbed and tolerated by humans, therefore it can be used in long courses instead of injections to reduce the traumatic impact of injections.

Many older people remember that vitamin B 12 was produced only in ampoules and was administered exclusively by injection, and therefore they are skeptical of the news about the availability of cyanocobalamin tablets that can be safely taken orally, like many other vitamins. However, at present, vitamin B 12 tablets are a reality, and their effectiveness and effect are not inferior to injections, which, according to some people, are quite painful and unpleasant. Therefore, if possible, then painful injections of vitamin B 12 can be replaced by taking pills.

In addition to tablets, vitamin B 12 is also currently available in the form of rectal suppositories, which are inserted into the rectum. These rectal suppositories are called Cycomin and are an excellent alternative to the injection of vitamin B 12, since the vitamin is very quickly absorbed from the rectum into the blood through the plexus of hemorrhoidal veins.

Complex preparations with vitamin B 12

Today, the following complex therapeutic preparations containing vitamin B 12 are available on the domestic pharmaceutical market:

• Angiovit (B 6, B 12 + folic acid);
• Binavit (B 6, B 1 and B 12 + lidocaine);
• Vitagamma (B 6, B 1 and B 12 + lidocaine);
• Vitaxon (B 6 , B 1 and B 12 + lidocaine);
• Combilipen (B 6 , B 1 and B 12 + lidocaine);
• Compligam B (B 6 , B 1 and B 12 + lidocaine);
• Medivitan (B 6 , B 12 and folic acid);
• Milgamma (B 6, B 1 and B 12);
• Multi-Tabs B-complex (B 1, B 2, B 3, B 5, B 6, B 12 + folic acid);
• Neurobion (B 6 , B 1 and B 12);
• Neuromultivit (B 6 , B 1 and B 12);
• Pentovit (B 1, B 3, B 6, B 12 + folic acid);
• Pitzian (B 6 and B 12);
• Trigamma (B 6, B 1 and B 12 + lidocaine);
• Ferro-Folgamma (B 12, folic acid and ferrous sulfate);
• Foliber (B 12 and folic acid.).

In addition to these therapeutic vitamins, the pharmaceutical market has a wide range of different complexes for the prevention of hypovitaminosis, such as, for example, Vitrum, Centrum, Supradin, Alphabet, etc. These complexes usually contain almost all vitamins and several minerals in the dosages recommended for the prevention of hypovitaminosis, which are relatively low, and therefore the funds cannot be used to treat various diseases. Typically, such complexes are called prophylactic and their main difference from therapeutic vitamins is the low dosage of the components, which is insufficient for therapeutic use. Vitamin B 12 is a part of almost any vitamin-mineral prophylactic complex in the dosage recommended for daily consumption. We do not give the names of these complexes, since the list will be too long.

Vitamin B 12 - indications for use

Indications for the use of all forms of vitamin B 12

• Chronic anemia (Addison-Birmer, iron deficiency, posthemorrhagic, aplastic, toxic, alimentary);
• Acute and chronic hepatitis;
• myelosis;
• Lateral amniotrophic sclerosis;
• diabetic neuropathy;
• Skin diseases (psoriasis, photodermatosis, herpetic dermatitis, neurodermatitis);
• Bone injuries;
• Polyneuritis;
• Radiculitis;
• Neuralgia;
• Causalgia.

Indications for the use of cyanocobalamin and cabamamide

• Injuries and inflammatory processes in the peripheral nerves (wound, radiculoneuritis, phantom pain);
• encephalomyelitis;
• Slow fusion of bones;
• To accelerate the recovery of the body after surgical interventions on the musculoskeletal system;
• Diseases of the digestive tract, in which the absorption of vitamin B 12 is impaired (resection of part of the stomach or small intestine, Crohn's disease, celiac disease, sprue);
• Prevention of vitamin B 12 deficiency when taking biguanides, para-aminosalicylic acid, large amounts of vitamin C (more than 100 mg per day);
• Malignant tumors of the pancreas and intestines;
• Prolonged stress;
• Long-term infectious diseases;
• kidney disease;
• Strict diet or vegetarianism.

Indications for the use of hydroxocobalamin

• Cyanide poisoning (intentional or accidental);
• Dystrophy or lack of body weight in newborns, including premature ones;
• Recovery after infectious diseases;
• Sprue;
• Trigeminal neuralgia;
• Leber's disease (hereditary atrophy of the optic nerves);
• Alcoholic psychosis ("white tremens").

Vitamin B 12 - instructions for use

How to inject vitamin B 12

Hydroxocobalamin can be administered as intramuscular or subcutaneous injections, cobamamide - intravenously and intramuscularly, and cyanocobalamin - intramuscularly, subcutaneously, intravenously or intralumbarly (in the lower back). The best methods of injecting vitamin B 12 are subcutaneous and intravenous. Intramuscular administration is the most dangerous and least preferred option for the use of vitamin B 12, so it is recommended to avoid this type of injection. Intralumbar administration of the vitamin is only used to treat neuritis or sciatica.

Subcutaneous or intramuscular injections can be made independently, and intralumbar and intravenous administration of drugs should be done by a doctor or nurse in a medical institution or at home.

Intramuscular injection is best done in the upper lateral surface of the thigh, and not in the buttock. Subcutaneous injection is optimally performed in the area of ​​\u200b\u200bthe inner surface of the forearm, where the Mantoux test is usually placed. Immediately before an intramuscular or subcutaneous injection, the skin area must be wiped with cotton wool moistened with an antiseptic solution (alcohol, chlorhexidine, Belasept, etc.). For intramuscular injection, it is necessary to insert the needle perpendicular to the skin and slowly release the drug into the tissues. The needle should also be removed while holding it perpendicular to the skin. For subcutaneous injection, it is necessary to collect 1 cm of skin into a fold with your fingers and insert a needle under it parallel to the forearm bone, and then slowly inject the solution into the tissues. Remove the needle without straightening the skin fold.

Before injection, a solution is prepared and drawn into a syringe. To do this, either an ampoule with a ready-made solution of the required concentration is simply opened, or the required amount of sterile distilled water is poured into the vial with lyophilizate so that the contents dissolve. The resulting or ready-made solution of vitamin B 12 is drawn into the syringe with a needle. Then the syringe is turned over with the needle up and a light tap on the surface of the tube is made with a fingertip in the direction from the piston to the needle. This is necessary so that the air bubbles break away from the walls of the syringe and rise to the surface of the solution. Then, by lightly pressing the piston, it is necessary to release a few drops of the solution from the syringe so that all the air comes out with them. After that, the syringe is considered ready for injection. It can be set aside on a clean surface and prepare the area of ​​​​skin in which the injection will be placed.

Dosages and duration of vitamin B 12 use depend on the type of disease, the rate of recovery and the age of the person. The course of therapy can vary from 7 to 30 days, and the dosage is from 10 mcg to 500 mcg per day. The specific dosage should be clarified with a doctor or in the instructions for use of a particular drug.

How to take vitamin B 12 by mouth

Vitamin B 12 in the form of tablets is recommended to be taken several times a day - from 2 to 6, depending on the frequency of meals. That is, if a person eats 3 times a day, then the daily dosage of vitamin B 12 is recommended to be divided into three doses, etc. The dosage and duration of the course of taking vitamin B 12 is determined by the rate of clinical improvement, as well as the condition for which the decision was made to use vitamin preparations. On average, the course of treatment can last from 7 to 30 days, and the dosage ranges from 250 mcg to 1000 mcg per day.

Vitamin B 12 Compatibility

So, when injected, vitamin B 12 is well compatible with vitamins B 6, C, U (U), H and folic acid. This means that cyanocobalamin can be administered simultaneously with compatible vitamins on the same day, but from different syringes. Despite compatibility, vitamin solutions should not be mixed in the same syringe, as this may lead to a weakening or complete loss of their therapeutic activity. Therefore, compatible vitamins are allowed to be administered at the same time, but from different syringes. If vitamins are administered intravenously, then this is done alternately, without removing the needle from the vein, with intervals between them of 5 to 10 minutes. If vitamins are administered intramuscularly, then each drug is drawn into a separate syringe and an injection is made in different places.

Vitamin B 12 is poorly compatible with vitamin B 1, so it is not recommended to administer them together. However, at present there are combined preparations containing both vitamins B 1 and B 12, which are administered simultaneously. In the form of such preparations, these vitamins can be administered simultaneously, since during the manufacturing process they are given special properties that make them compatible.

Vitamin B 12 is completely incompatible with copper, iron and manganese.

Vitamin B 12 for hair

Vitamin B12 injections are prescribed to treat vitamin B12 deficiency.

A lack of this essential nutrient can lead to a host of health problems, ranging from chronic fatigue to permanent neurological changes.

This article discusses the importance of maintaining healthy B12 levels and outlines the benefits and risks associated with vitamin B12 injections.

What is vitamin B12?

Vitamin B12 is a water-soluble vitamin that plays an important role in many bodily functions:

1. DNA synthesis
2. Energy production
3. Nerve cell health
4. Formation of red blood cells
5. Neurological function

B12 is found in many food sources (mostly animal sources) where it is associated with protein molecules in that food.

Vitamin B12 is separated from protein during digestion and absorbed into the bloodstream.

Gastric juice is required to extract the vitamin from protein, and a substance called intrinsic factor is required for its absorption.

People whose bodies are unable to absorb vitamin B12 have pernicious anemia, a type of anemia characterized by the absence of intrinsic factor.

The average daily intake of vitamin B12 recommended by the Dietary Supplement Administration is 2.4 micrograms (mcg) for men and women over 14 years of age. Pregnant and lactating women require a little more - 2.6 mcg and 2.8 mcg, respectively.

Synthetic Vitamin B12

In addition to getting B12 from food, you can replenish your body's B12 levels with a synthetic version of the nutrient known as cyanocobalamin.

Vitamin B12 - injections with a high concentration of cyanocobalamin. Injections are aimed at solving the problem of vitamin I12 deficiency in the body.

Cyanocobalamin comes in a variety of forms: liquid, tablet, or capsule.

Certain foods, such as grains and dairy products, may be fortified with a synthetic form of vitamin B12.

Who needs supplemental B12?

B12 supplements and foods fortified with the vitamin are readily available. Vitamin B12 injectable capsules are only available by prescription, so a clinical diagnosis is always required to prescribe them.

It is important to note that a lack of vitamin B12 in the body is rare, since the liver stores a supply of vitamin for several years.

Common signs and symptoms of vitamin B12 deficiency:

1. Cognitive decline: problems with memory or perception of information

2. Fatigue

3. Lethargy

5. Feeling weak

6. Depression and irritability

7. Headache

8. Difficulty maintaining balance

9. Sore, swollen tongue that is pale yellow or very red

10. Rapid heartbeat

11. Mouth ulcers

12. Paresthesia

13. Vision problems

Risk factors for B12 deficiency

The following risk factors may increase your chance of developing a vitamin B12 deficiency:

1. Alcohol abuse
2. Smoking
3. Some prescription drugs, including antacids
4. Having diabetes or thyroid disease
5. Gastrointestinal disorders such as Crohn's disease
6. Gastric bypass or removal of parts of the stomach
7. Old age
8. The presence of diseases of the gastrointestinal tract

A gastrointestinal tract that is not functioning properly can inhibit the release or absorption of vitamin B12. For this reason, people with disorders such as celiac disease and Crohn's disease are at higher risk of vitamin B12 deficiency.

Individuals who have undergone gastrointestinal surgery (such as weight loss surgery) have a reduced number of cells needed for gastric acid secretion and intrinsic factor.

Vitamin B12 injections, rather than oral supplements, are especially helpful for people who have gastrointestinal problems because injections tend to bypass it.

Elderly people

Studies show that vitamin B12 deficiency develops in a large number of people over 65 years of age.

This may be due to decreased gastric acid production, including inflammation in the stomach (atrophic gastritis).

Low levels of stomach acid stimulate the growth of bacteria in the gut that absorb B12, lowering overall levels of the vitamin in the body.

The Institute of Medicine recommends that adults over the age of 50 meet their vitamin B12 needs with vitamin fortified foods, B12 injections, and other supplements.
Synthetic forms are easier to digest than natural B12.

Benefits of Vitamin B12 Injections

B12 injections actively reduce the risk of developing serious conditions associated with vitamin B12 deficiency, including:

1. Heart disease
2. Neurocognitive disorders
3. Coordination problems (ataxia)
4. Peripheral neuropathy
5. Loss of vision
6. Infertility
7. Neural tube defects in infants born to women with vitamin B12 deficiency
8. High assimilation rate

Injections of B12 shots bypass the stomach and are absorbed directly into the bloodstream.

This is why they are safer and more effective than oral supplements, especially for people with gastrointestinal problems.

Side effects and potential risks

An overdose of vitamin B12 is not possible, as there is no upper limit for vitamin B12 intake.

However, B12 injections can cause side effects:

1. Pain, redness or itching at the injection site
2. Mild diarrhea
3. Edema

Serious side effects requiring immediate medical attention:

1. Muscle spasms
2. Arrhythmia
3. Causeless weakness or fatigue
4. Swelling of the ankles or feet

Severe reactions are very rare, but require emergency intervention. These include:

1. Itching and swelling of the face, throat or tongue
2. Difficulty breathing
3. Severe dizziness
4. Sudden change in vision
5. Slurred speech

Interaction with drugs

Vitamin B12 may interact with certain medications. Before you start taking B12, you should consult with your doctor.

Popular drugs that interact with B12:

1. Aspirin
2. Antibiotics
3. Antagonists of h2 receptors
4. Metformin
5. Oral contraceptives
6. Proton pump inhibitors

Allergies and medical contraindications

The presence of allergies or other medical contraindications must be reported to the doctor.

Examples of allergies or conditions for which B12 injections are prohibited:

1. Allergy to cyanocobalamin or cobalt
2. Hypokalemia (low potassium level)
3. Kidney disease
4. Polycythemia vera (rare blood disease)
5. Leber's disease (eye disease)
6. Deficiencies in other nutrients, especially folic acid and iron

B12 is adequate in most people's diets, but after the age of 50, in some cases, the body's ability to absorb B12 from food decreases dramatically. Supplements are usually recommended because even a small deficiency can increase the risk of heart disease, depression, and Alzheimer's disease.

Composition and form of release

Release form Vitamin B12:

• Tablets
• Capsules
• flat cakes

Solubility: Water soluble.

Application Tips

The presence of a sufficient amount of the substance in the body can slow down the transition from HIV infection to AIDS. This was shown in the course of observations of 310 HIV-infected men. Elderly people who are mildly deficient may have reduced efficacy of the pneumonia vaccine. In the course of observations of 30 elderly people, it was shown that those of them who have insufficient supplies of the drug produce less antibodies to the pneumonia virus after vaccination than people with a normal level of this drug.

Indications for the use of vitamin B12

Instructions for use notes that this drug is necessary for the formation of red blood cells. In addition, it is involved in the synthesis of iron, vitamins B5, B9, C and choline. Its absence in the body leads to severe fatigue, which is especially common in vegans (vitamin B12 is practically not found in plant foods). It contributes to the normal functioning of nerve cells because it is involved in the production of myelin, the white sheath of nerve fibers.

• To prevent some forms of anemia
• To relieve symptoms of depression
• For neuralgia, numbness and tingling
• For the prevention of heart disease
• For multiple sclerosis and tinnitus (tinnitus)

Contraindications

• If you are taking B12 supplements, you also need folic acid. Taking large doses of one of these substances may mask a lack of the other.
• Large amounts of alcohol interfere with the absorption of the drug.
• If you are ill or under the supervision of a psychiatrist, please consult your physician before using these supplements.
• When taking sublingual (under the tongue) forms, the absorption of vitamins occurs better.

Side effects

The medicine in tablet form does not cause side effects. However, serious allergic reactions to vitamin B12 injections are possible, although they are rare. Patients with a rare eye disease - Leber's disease, should consult a doctor before taking.

Instructions for use

A regular multivitamin tablet contains 50-100 kg of the drug, and this amount is enough to prevent its deficiency. To prevent heart disease, with pernicious anemia, numbness and tingling in the limbs, tinnitus, multiple sclerosis and rosacea, 1000 mcg per day is required. If a B12 deficiency is detected in a blood test, it may be due to a lack of intrinsic factor, in which case high doses of the drug may be required. Check with your doctor.

500-100 mcg with a full complex of B vitamins. Well absorbed in the form of lingual tablets. The daily recommended dose is 2.4 mcg. For pregnant women, it is 2.6 mcg, for lactating women - 2.8 mcg. The European recommended dose is 1 mcg. The US National Academy of Science recommends that people over age 50 meet their vitamin B12 needs with fortified foods or vitamin supplements.

Maximum safe dose: 3000 mcg (for single and long-term use; adverse effects have not been established) is generally considered safe, although the maximum allowable dose has not been officially established.

Method and dosage

• Take once a day, preferably in the morning, along with folic acid (at least 400 mcg).
• Most multivitamin complexes contain at least the recommended dose of the drug and folic acid; Vitamin B complexes contain them in large quantities. If even larger, therapeutic doses are required, look for B12 supplements with folic acid.

Medicinal properties

The so-called cobalamin was discovered the last of the vitamins of this group. It was discovered in the late 1940s in the liver of a calf and used to treat pernicious anemia, a deadly disease that occurs primarily in the elderly. This substance is the only vitamin from group B, accumulated by the body in large quantities, especially in the liver. The body absorbs this vitamin through a very complex process. Digestive enzymes, in the presence of sufficient stomach acid, separate the vitamin from the proteins present in the food. Then the vitamin combines with the so-called intrinsic factor (a protein secreted by cells lining the stomach), after which it enters the small intestine and is absorbed.

Decreased stomach acid or insufficient intrinsic factor (this may be due to age) can lead to B12 deficiency, but due to the large body stores, it can take several years for a serious deficiency to develop.

The mechanism of action of the vitamin

Instructions for use indicate that the substance is necessary for cell reproduction and is especially important for the formation of red blood cells. It preserves the protective sheath of nerves (myelin), is involved in the conversion of food into energy and plays an essential role in the formation of DNA and RNA genetic material of cells.

Disease prevention

A moderate increase in the level of homocysteine ​​in the blood leads to an increased risk of developing heart disease. Together with folic acid, it helps the body process homocysteine, thus reducing this risk. B12 supplementation can help prevent a range of neurological disorders, as well as the numbness and tingling that often accompanies diabetes. It may also play a role in the treatment of depression.

Impact on the human body

Studies have shown that in patients with Alzheimer's disease, the level of the drug is usually reduced. Whether the deficiency is a factor determining the development of the disease, or its result, is still unknown. This vitamin is required to maintain the immune system, an adequate intake of vitamins improves the immune status of the elderly. By having a positive effect on the nerves, the drug can reduce ringing in the ears (tinnitus). As a component of myelin, it can be taken in the treatment of multiple sclerosis, a disease in which demyelination of nerve fibers occurs. Due to its role in cell reproduction, the use of the drug can be useful in rosacea.

The body's need for vitamin B12

Signs of a shortage of funds

Possible deficiency symptoms include fatigue, depression, numbness or tingling of the extremities, muscle weakness, confusion, and memory loss. Dementia and pernicious anemia may develop. Blood levels decrease with age. The risk of deficiency is high in patients with ulcers, Crohn's disease, or other gastrointestinal disorders, and in patients taking medications for epilepsy (anticonvulsants), chronic heartburn, or gout.

Vitamin B12 deficiency symptoms

Deficiency causes fatigue. Back in the 70s, a double-blind experiment conducted by Ellis showed that even in individuals who did not have a B12 deficiency, their tone increased after injections. Recently, this vitamin has begun to be studied as a treatment for chronic fatigue syndrome (CFS). In a preliminary trial conducted by Drs. Lapp and Cheney, 50% to 80% of patients suffering from this syndrome, after injections of 2500 to 5000 micrograms of B12 every two to three days, recognized a significant improvement in well-being.

B12 deficiency is associated with pernicious anemia, the symptoms of which include weakness, tender and inflamed, reddened tongue, numbness and tingling in the limbs, pallor, weak pulse, chilliness, drowsiness, irritability, depression, mental disorders, as well as senile dementia, paranoid psychosis, chronic fatigue syndrome, diarrhea, poor appetite, growth disorders in children. Health experts estimate that at least one in five adults is deficient in B12. B12 supplementation may be beneficial for the elderly, those with gastrointestinal disorders (gastritis or gastrectomy), those with autoimmune disorders (including type I or insulin-dependent diabetes mellitus and thyroid disease), and those on long-term use of inhibitors gastric juice or biguanides. Since vitamin B12 is not found in plant foods, unless it is artificially fortified with vitamins (such as breakfast cereals), vegans are prone to developing a lack of this vitamin, so it is advisable to take it in addition.

Signs of an excess of Vitamin B12 when using

Excess amounts of the drug are excreted in the urine, so the use of large doses does not entail negative consequences.

The main source of vitamin B12 is animal foods (offal, oysters, sardines and other fish, eggs, meat and cheese) and brewer's yeast. This vitamin is added to some brands of breakfast cereal.

Price in pharmacies

The price of Vitamin B12 in different pharmacies can vary significantly. This is due to the use of cheaper components and the pricing policy of the pharmacy chain.

Read the official information about the Vitamin B12 preparation, the instructions for use of which include general information and a treatment regimen. The text is provided for informational purposes only and is not a substitute for medical advice.