Vitamin B12 in ampoules. Cyanocobalamin (vitamin B12): instructions for use. Rules for taking Cyanocobalamin: dosage and indications Cyanocobalamin orally

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: Transparent liquid from slightly pink to bright red.

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 metabolic and hematopoietic effects. In the body (mainly in the liver) it is converted into a coenzyme form - adenosylcobalamin, or cobamamide, which is the active form of vitamin B 12 and is part of numerous enzymes, incl. part of a reductase that reduces folic acid to tetrahydrofolic acid. Has high biological activity.
Cobamamide is involved in the transfer of methyl and other one-carbon fragments, therefore it is necessary for the formation of deoxyribose and DNA, creatine, methionine - a donor of methyl groups, in the synthesis of lipotropic factor - choline, for the conversion of methylmalonic acid and succinic acid, which is part of myelin, for the utilization of propionic acid acids. Necessary for normal hematopoiesis - promotes the maturation of red blood cells.
Promotes the accumulation of compounds containing sulfhydryl groups in erythrocytes, which increases their tolerance to hemolysis. Activates the blood coagulation system, in high doses causes an increase in thromboplastic activity and prothrombin activity. Reduces blood cholesterol levels. 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 elderly people -1.2-1.4 mg; for women - 1-2 mg (for pregnant women - 0.5 mg more, for lactating women - 0.6 mg more); 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. 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. 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 and breast milk.

Indications for use
Conditions accompanied by vitamin B12 deficiency:
Chronic anemia occurring with deficiency of vitamin B 12 (Addison-Birmer disease, alimentary macrocytic anemia), as part of 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 origin, amyotrophic lateral sclerosis, cerebral palsy, Down's disease.
In dermatology: psoriasis, photodermatosis, dermatitis herpetiformis, atopic dermatitis.
For preventive purposes- when prescribing biguanides, PAS, ascorbic acid in high doses, pathology of the stomach and intestines with impaired absorption 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 period.

Carefully
Angina pectoris, benign and malignant neoplasms, accompanied by megaloblastic anemia and vitamin B12 deficiency, a tendency to form blood clots.

Directions for use and doses
The drug is used subcutaneously, intramuscularly, intravenously and intralumbarally.
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 doses of up to 5-7 days (folic acid is prescribed at the same time); during the period of remission, the maintenance dose is 100 mcg/day 2 times a month, and in case of dysfunction of the nervous system, 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 disorders of the nervous system - 200-400 mcg 2-4 times a month.
For diseases of the central nervous system and peripheral nervous system - 200-500 mcg every other day for 2 weeks.
For diseases of the peripheral nervous system of traumatic origin - 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 radiation sickness - 60-100 mcg daily for 20-30 days. For funicular myelosis, amyotrophic lateral sclerosis - intralumbarally, 15-30 mcg with a gradual increase in dose to 200-250 mcg per injection.
To eliminate vitamin B 12 deficiency, 1 mg is administered intramuscularly or intravenously for 1-2 weeks.
For young children with nutritional anemia and premature babies - 30 mcg subcutaneously per day daily for 15 days. For 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 - hypercoagulation, disruption of purine metabolism.

Interaction with other drugs
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). Cannot be combined 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.
Strengthens 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 folic acid deficiency. During the treatment period, it is necessary to monitor peripheral blood parameters: on the 5-8th day of treatment, the content of reticulocytes and iron concentration are determined. The number of red blood cells, 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 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 content of reticulocytes normalizes after a reticulocyte crisis. After achieving hematological remission, peripheral blood monitoring is carried out at least once every 4-6 months.
Use caution in persons prone to thrombosis and angina pectoris (in smaller doses up to 0.1 mg per injection). Take for a long time for pernicious anemia, upcoming operations on the gastrointestinal tract. When taking the recommended doses during pregnancy, breastfeeding, as well as in the elderly, no adverse reactions other than those listed above were noted.

Release form
1 ml per ampoules. 10 ampoules per pack of cardboard with a knife for opening ampoules or an ampoule scarifier.

Best before date
2 years.
Do not use after the expiration date stated on the package.

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

Conditions for dispensing from pharmacies
On prescription.

Manufacturer
OJSC "Yerevan Chemical-Pharmaceutical Company"
Russia 375040, Armenia, Yerevan, st. Adzharyan 2nd lane, No. 6.

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

Pharmacologically vitamin B 12 (cyanocobalamin) is a water-soluble vitamin. At the same time, there is high activity in relation to biochemical and physiological processes. It is necessary in the body for many processes: the synthesis of red blood cells, participates in the transfer of hydrogen, the formation of many substances (choline, methionine, nucleic acids, creatine). It has a direct beneficial effect on nervous tissue, as well as the liver. Activates the blood coagulation system; in extremely high doses it can increase the activity of prothrombin and thromboplastin.

Pharmacokinetically it is absorbed into the blood after intramuscular injection, and is also quickly and completely absorbed orally after ingestion from the gastrointestinal tract. Metabolism begins in the tissues, turns into a coenzyme form, which is the active form - adenosylcobalamin. It is excreted both through the liver with bile and with urine.

Indications

In neurological practice, there are many indications for the use of vitamin B 12. Among them, the following conditions should be highlighted:

• Radiculopathies
• Down's disease
• Injury to peripheral nerves and plexuses
• Funicular myelosis

It is also used for anemia due to vitamin B12 deficiency, in dermatological practice for dermatoses, dermatitis, psoriasis, alopecia, radiation sickness, and other conditions. Can be used to improve the condition and appearance of hair.

Contraindications

There are a number of conditions in which taking vitamin B12 is contraindicated:

• Thromboembolic conditions
• Erythrocytosis
• Allergic reactions and sensitivity to vitamin B12

Mode of application

Vitamin B 12 injections are used subcutaneously, intramuscularly and intravenously, and can also be used intralumbarally.

The dosages used vary greatly depending on the conditions, the therapeutic corridor (dose range used) is wide:

• Funicular myelosis. 500 mcg 7 days in a row, then once a week for a long time. When remission is achieved, a dose of 100-200 mcg is used 2 times a month.
• Diseases of the central and peripheral nervous system. For pain syndromes, 200-500 mcg (up to 1000). For injuries, 200-400 mcg every other day for 40-45 days.
• Polyneuropathy - 100 mcg daily for 1 month.
• Radiation sickness - 60 mcg daily for 1 month.
• In case of amyotrophic lateral sclerosis, to set up Katlen blockades, funicular myelosis, 200-250 mcg can be injected into the spinal canal.

From the author. In my practice, I often use a dose of 500 mcg for 10 days in a row. For severe pain, you can use a dose of 1000 mcg for 10-15 days in a row. Also, note, 1 ml of solution contains 200 or 500 mcg of vitamin B12, see the dose on the package (0.2 mg per 1 ml = 200 mcg per 1 ml, 0.5 mg = 500 mcg per 1 ml).

Side effects

Side effects are rare. More often these are allergic reactions. Rarely observed states of excitement and anxiety, pain in the heart, palpitations.

Overdose

No reliable cases of true overdose have been described. Long-term course intake of vitamin B 12 in high doses can lead to erythrocythemia and thrombosis (theoretically).

special instructions

There are a number of guidelines that you should read before using vitamin B 12.

• Taking with hormonal contraceptives may reduce the level of vitamin in the blood.
• Vitamin B 12 may increase allergic reactions to vitamin B1.
• Parenteral use of chloramphenicol preparations leads to a decrease in effectiveness in anemia.
• Vitamin B 12 is incompatible with ascorbic acid, vitamin B1 (in bromide salt), and riboflavin in the same solution.

Use with caution in high doses for angina. It is necessary to control blood clotting and avoid increasing it.

Storage conditions

Store in a place protected from light, at room temperature. Some complex preparations require storage in the refrigerator.

Video material by the author

Analogs

There are no analogues of vitamin B 12, because it is an active substance in itself. However, there are many different drugs that are monovitamin B12 or are complex drugs (including Combilipen, etc.).

Price

Prices vary greatly depending on the manufacturer, the pharmacy markup, and also on whether a single drug or a complex drug is used. Average prices for the drug vary from 25 to 300 rubles per package of 10 ampoules of 1 ml.

Much has already been said about the benefits of B vitamins. Its representatives are of paramount importance. For example, in order for a woman to have a dazzling appearance, she must regularly replenish her body with them. They are available and can be purchased at any pharmacy. Vitamins are packaged in ampoules and can be either water or oil based.

The role of vitamin B12 in the body

Cyanocobalamin (vitamin B12) was discovered in 1948. It was isolated from raw liver. For a long time, scientists could not understand why patients who took raw liver in small quantities managed to overcome pernicious anemia.

Since then, vitamin B12 and its effect on the body have been studied quite well; all that remains is to understand that this is an expensive gift from nature that should be used wisely. Vitamin B12 helps to avoid the effects of stress; it is the one that, with the help of vitamins B5, B9 and C, helps block stress hormones, helps restore nerve cells and is involved in the construction of new ones, that is, it is an active participant in the processes of biosynthesis of amino acids and the synthesis of DNA and RNA. The substance improves the process of blood clotting and reduces the amount of cholesterol in it.

Vitamin B12 can be obtained from food or supplemented with tablets and injections. Cyanocobalamin is found in animal products, which is why vegetarians tend to suffer from a lack of it in the body. It is not synthesized in plants.

Uses of Vitamin B12

It is much more convenient to use vitamin B12 in ampoules. It is a slightly pink liquid. Indications for cyanocobalamin injections may include trigeminal neuralgia, hepatitis, neurodermatitis, anemia, Down syndrome, as well as migraine, diabetic neuritis, radiation sickness, multiple sclerosis, cerebral palsy. This vitamin affects reproductive function - both female and male. Has a beneficial effect on the human immune system. If the body of HIV-infected people does not have enough vitamin B12, the disease progresses much faster.

B12 injections should not be prescribed in the presence of erythrocytosis or hypersensitivity to the drug; caution must also be exercised in case of malignant and benign tumors and angina pectoris.

How to give vitamin B12 injections correctly

As mentioned above, vitamin B 12 belongs to the group of vitamins. It is widely used in traditional medicine as one of the components used to treat various diseases or for their prevention. Therefore, if cyanocobalamin is prescribed by a doctor, then this is not subject to discussion, but if someone independently decided to inject vitamin B12 in ampoules, the instructions for use in this case are subject to detailed study.

First of all, you need to know that cyanocobalamin can be used intravenously, subcutaneously, intramuscularly. And the instructions also detail that it cannot be used together with drugs that increase blood clotting; you also cannot mix vitamins B1, B6 and B12 in one syringe; in addition, if the patient has an allergic reaction to vitamin B1, then B12 can significantly strengthen. You cannot combine cyanocobolamin with riboflavin and ascorbic acid, but colchicine, antiepileptic drugs and salicylates can reduce the degree of its absorption by the body. And there are many nuances that only a doctor can know, so only he can fully answer the question of how to inject vitamin B12.

Use of vitamin for various diseases

Headache and dizziness;

Fatigue and weakness;

Irritability, neuritis and nervousness;

The appearance of ulcers on the tongue and in the mouth;

Paleness of the skin;

Numbness;

Decreased appetite, back pain and sleep disturbances.

This drug is prescribed by doctors for certain diseases and for their prevention. For what diseases is B12 prescribed, how to inject it correctly?

The course of prophylaxis can range from 7 to 15 days, with injections from 200 mcg to 500 mcg per day.

Diseases associated with the central and peripheral nervous system:

The first 3 days, 200 mcg daily;

The next 4 days, 300 mcg daily.

If no complications arise within seven days, the course of treatment ends. If complications occur, the dose is increased:

5 days daily 400 mcg;

The next 3 days, 500 mcg daily.

Another quite serious disease that occurs due to a lack of B12 in the body is anemia. A characteristic feature of this ailment is that it develops almost asymptomatically and slowly, but, as a rule, affects the nervous system. During treatment, cyanocobalamin is prescribed along with other drugs in a dose of 200 to 300 mcg; if complications arise, it is increased to 500 mcg and administered 1 or 2 times a day. If the patient's condition worsens, the dose can reach up to 1000 mcg. After 10 days it can be reduced, but for another 3 months the daily norm will be 300 mcg of the vitamin. And after the end of treatment, one injection is given every two weeks for six months.

Vitamin B12 overdose

Before injecting vitamin B12 in ampoules, it would be useful to familiarize yourself with the consequences in case of an overdose: if the body is hypersensitive to this substance, then a large dose can cause an allergic reaction, which will manifest itself in the form of urticaria (rash on the body and mucous membranes), as well as pain in the heart area, tachycardia, increased nervousness.

It should be remembered that an excess of cyanocobalamin is very difficult to remove from the body.

Vitamin B12 in hair care

Cyanocobalamin is an excellent assistant in hair care. At home, the vitamin can be added to shampoo, thereby making it fortified. It is also added to hair masks. For example, an excellent mask against hair loss is to mix one teaspoon of honey and lemon juice and add one ampoule of vitamin B6 and B12 to the mixture. Apply the mixture to clean hair, leave for 10 minutes, then rinse. Repeat the procedure five times a week.

But, as you know, external application is always inferior in results to internal application. What to do if vitamin B12 cannot be used in the form of injections due to the individual characteristics of the body, but at the same time you want to have beautiful hair? In such cases, it is best to include foods containing cyanocobalamin in sufficient quantities in your diet.

What foods contain vitamin B12

The most vitamin B12 is found in beef or veal liver, but chicken and pork liver also contain it in large quantities. It is also found in marine products such as crabs and oysters, fish, egg yolks, meat, hard cheese, dairy and fermented milk products.

Nowadays, fortified mixtures are offered in large quantities, for example, oatmeal, muesli in the form of breakfast cereals. In fact, it is unlikely that it will be possible to find the specified amount of vitamins there, because long-term storage helps to reduce it, and the preservatives contained in such products are harmful.

There is another caveat: vitamin B 12 is heat stable, which means it is not destroyed by cooking. But at the same time, direct sunlight has a detrimental effect on it.

is a drug that promotes tissue healing processes, improves the functioning of the central nervous system, and helps normalize the blood circulation process.

The main active ingredient of Cyanocobalamin is vitamin B12, which has special biological activity.

Cyanocobalamin improves the process of hematopoiesis, as it promotes the formation of red blood cells, supports the liver, and helps normalize blood clotting.

Cyanocobalamin is presented in the form of tablets, capsules, ampoules for injections and injections. The drug is dispensed from pharmacies only with a doctor's prescription. The description of the drug will allow you to clarify information regarding indications and contraindications, dosage, and the possibility of simultaneous use with other drugs.

Description and composition of the drug

Name

Trade names:

Cyanocobalamin (Vitamin B12)

Cyanocobalamin injection solution

Vitamin B12

Cyanocobalamin-Vial

Tsikomin-Altfarm

Vitamin B12 crystalline

Cyanocobalaminbufus

Drug formula: С63H88CoN14P

Pharmacological action: refers to vitamins and vitamin-like agents, helps normalize hematopoiesis, has a beneficial effect on the liver and nervous system, stimulates hematopoiesis and nucleic acid metabolism, promotes normal blood clotting, supports normal production and growth of red blood cells, increases the activity of thromboplastin and prothrombin. Cyanocobalamin has high biological activity, normalizes tissue regeneration, fat, carbohydrate, and protein metabolism. The drug lowers the amount of cholesterol in the blood.

Main indications for the use of Cyanocobalamin

The drug Cyanocobalamin is prescribed to patients in the complex therapy of a wide range of diseases, primarily for anemia caused by various causes.

We list a number of diseases for which the use of Cyanocobalamin is indicated:

• Various forms of anemia and chronic anemia associated with a lack of vitamin B12;
• Addison-Beerman disease;
• Chronic hepatitis;
• Cirrhosis of liver tissue;
• Nephrosis and necrosis of the liver;
• Kidney dysfunction;
• Down's disease;
• Cerebral palsy;
• Alcoholism;
• Prolonged fever, which lasts more than 1–2 weeks;
• Polyneuritis;
• Attacks of neuralgia;
• Amyotrophic lateral sclerosis.

Cyanocobalamin is often prescribed in the treatment of various skin diseases and dermatitis. It is indicated for diseases such as:

• psoriasis;
• allergic and atopic dermatitis;
• Dühring's dermatitis;
• severe forms of photodermatitis.

Cyanocobalamin is often prescribed as an additional drug that helps relieve various symptoms and is used for the following diseases:

• radiation sickness;
• migraine;
• malignant neoplasms in the intestine;
• long-term course of infectious diseases, against the background of which there is a decrease in immunity and various complications;
• kidney diseases.

The drug Cyanocobalamin is also used for prevention. For this purpose, it is prescribed by doctors for such disorders and diseases as:

• stomach pathologies of various types;
• impaired absorption of vitamin B12 by the body;
• Crohn's disease;
• diseases accompanied by poor bowel function;
• malabsorption - impaired absorption of nutrients in the digestive tract.

The drug Cyanocobalamin is prescribed only by a doctor, as a rule, it is used in the form of injections; for each patient, the doctor selects an individual course of treatment and the required dosage.

Self-medication with the drug is strictly prohibited.

Possible side effects of the drug

In general, the drug is well tolerated. Some negative symptoms usually occur when the drug is used incorrectly and the dosage is incorrectly calculated.

Here is the main list of side effects of Cyanocobalamin:

1. Allergic reactions: itching, urticaria, rash, rarely - Quincke's edema, anaphylactic shock;
2. From the central nervous system, headache, dizziness, overexcitation are possible;
3. Attacks of tachycardia;
4. Pain in the left side of the chest - cardialgia;

If the dose of the drug is exceeded, a violation of purine metabolism and hypercoagulation is possible. In addition, sometimes local reactions of the body occur at the injection sites (necrosis and compaction at the injection site). Sometimes when using the drug, nausea, weakness, sweating, and swelling are possible.

If any of the symptoms described above or other negative manifestations detected while taking the drug are detected, you must consult a doctor to clarify the dosage of the drug or its discontinuation.

Contraindications for use

Cyanocobalamin has a number of contraindications; you must carefully read the instructions for use. Sometimes taking the drug can worsen the patient's condition. The main prohibitions for taking the drug are:

• special sensitivity to certain components of the drug, allergic reactions;
• erythremia, erythrocytosis;
• thromboembolism;
• pregnancy and lactation;
• children's age (up to 3 years);
• angina pectoris;
• benign and malignant formations.

Before prescribing Cyanocobalamin to a patient, an examination is carried out to confirm the need for the drug. Only a doctor can prescribe and discontinue a drug and adjust treatment.

Use of Cyanocobalamin during pregnancy

Cyanocobalamin is strictly contraindicated in pregnant women, regardless of the stage of pregnancy. B vitamins can negatively affect the condition of the fetus. Cyanocobalamin is also contraindicated for women during lactation, since the medicine is well absorbed and can enter the child’s body with milk and cause harm to him.

Interaction of Cyanocobalamin with other drugs

Before starting to take the drug, the doctor informs patients about the possible use of Cyanocobalamin with other drugs, about the need to study the official instructions, since taking it in combination with certain medications can cause complications and many side effects.

We list the main medicinal substances with which Cyanocobalamin is not compatible:

1. Cyanocobalamin should not be taken simultaneously with ascorbic acid;
2. Cyanocobalamin is not compatible with heavy metal salts;
3. It is not recommended to take the drug simultaneously with riboflavin;
4. Salicylates, as well as aminoglycosides and tetracyclines, significantly reduce the absorption of Cyanocobalamin;
5. It is forbidden to take Cyanocobalamin with other drugs that increase blood clotting;
6. Cyanocobalamin is not allowed to be mixed with B vitamins: B1, B6, B12 (in another form), with other injection solutions;
7. Cyanocobalamin enhances the development of allergic reactions caused by thiamine.

Before prescribing Cyanocobalamin, like any other medicine, it is necessary to promptly inform the attending physician about the medications the patient is taking, since only a doctor can draw up an individual complex treatment regimen, minimizing the side effects of the drug.

Dosage and duration of taking the drug

Cyanocobalamin is available in the form of glass ampoules for injection. Does not require breeding. Treatment with the drug is prescribed by a doctor, who also determines the method of introducing the drug into the body (subcutaneous, intramuscular, intravenous or intralumbar).

Depending on the disease and its severity, vitamin B12 deficiency, different dosages and different frequency and duration of taking the drug are prescribed.

• When treating vitamin B12 deficiency, intravenous administration of the drug is prescribed at a dose of 200 mcg. per day.
• When treating anemia, injections of 500 mcg are prescribed. drug per day. During the first week of treatment, injections with Cyanocobalamin are given every day; after a week, injections are given once every 5 days, until the patient recovers.
• Anemia due to iron deficiency is treated using Cyanocobalamin injections, which are given three times a week, using a dosage of 100 mcg. drug.
• For diseases of the central nervous system and neuralgia with severe pain, Cyanocobalamin is prescribed at a dose of 300–400 mcg. in the form of injections for two weeks. Typically, the course of treatment for such diseases is not reduced, but if the patient’s condition quickly improves, the dosage of the drug is reduced to 100 mcg. in a day.
• Damage to peripheral nerves takes longer to treat, over 40 days. With this diagnosis, injections of 300 mcg are prescribed. medications, which are taken every two days.
• For radiation sickness, the course of treatment with the drug is a month, injections are given every day, injecting 80 mcg into the body. drug.
• If a patient is diagnosed with a serious spinal cord disease, Cyanocobalamin is injected into the spinal cord canal, gradually increasing the dosage, starting with 30 mcg: first 30, then 50, 100, 150 and 200 mcg. drug. The dosage of the drug is increased during each subsequent injection. In this case, cyanocobalamin is administered intralumbarally, every 3 days. As a rule, 7–10 injections are given, after treatment the patient is prescribed maintenance therapy - 100 mcg. Cyanocobalamin twice a month. If symptoms of the disease return, maintenance therapy is increased to 4 injections per month, administering 300 mcg each time. drug.

Consecutive treatment with Cyanocobalamin under the supervision of a physician cannot cause an overdose. An overdose of the drug is possible only if the patient does not comply with the treatment regimen - instructions on the amount of medication and the time of its use. In case of deviation from the complex therapy established by the doctor and the method of taking the medicine in the direction of increasing the dose of Cyanocobalamin, various complications are possible:

1. pulmonary edema;
2. problems with heart function, heart failure;
3. peripheral vascular thrombosis;
4. hives;
5. in rare cases, with a significant overdose, anaphylactic shock is possible.

If symptoms of the above conditions are detected, the patient should immediately go to the hospital and stay in a medical facility, under the supervision of medical workers until the symptoms appear completely disappear.

Vitamin B12 deficiency

Vitamin B12 deficiency leads to damage to the circulatory system, hematopoietic tissue, deterioration of function and diseases of the nervous and digestive systems of the body.

With vitamin deficiency associated with a lack of vitamin B12, pernicious anemia and funicular myelosis develop, most often combined with megaloblastic anemia. With hypovitaminosis, mild paresthesia appears in the extremities, a burning sensation of the tongue, and macrocytic anemia develops.

Increased levels of vitamin B12

Significantly elevated levels of vitamin B12 are rare in healthy people. A small increase in the vitamin content in the body, as a rule, does not harm a person, since excess amounts of vitamin B12 are easily excreted along with bile.

An increased and not decreasing amount of vitamin B12 may indicate cancer, chronic leukemia, as well as serious diseases and malignant tumors of the liver.

Foods High in Vitamin B12

Vitamin B12 is found exclusively in foods of animal origin. It is especially abundant in the liver, kidneys of animals, and some types of fish. For comparison and clarity, we present a table illustrating the content of vitamin B12 in various products:

Doctors advise eating in such a way that the daily consumption of foods containing vitamin B12 is portioned: the vitamin will be better absorbed when entering the body in small portions. According to recent studies, the absorption of small portions of vitamin B12 is 70% better than the absorption of large portions of the vitamin, the remains of which are quickly eliminated from the body as excess.

Importance of Cyanocobalamin

Cyanocobalamin is a participant in many important processes that occur in the human body. Cyanocobalamin, along with vitamin C, as well as pantothenic and folic acids, plays a large role in protein, fat and carbohydrate metabolism. It provides the structure of the myelin sheath of nerve fibers.

Cyanocobalamin is very important in the fight against stress; it increases the body’s resistance through the synthesis of choline, promotes the accumulation of iron and maintains its normal level in the human body.

It is Cyanocobalamin that contributes to the beginning of the synthesis of DNA and RNA molecules, the formation of that protein substance that contains and stores all the information about human genes.

Analogues of the drug

In complex therapy, doctors sometimes replace Cyanocobalamin with its analogues, drugs with a similar effect: sometimes these are drugs with the same active ingredient as Cyanocobalamin, sometimes with a different active substance. When prescribed regularly and correctly, Cyanocobalamin analogues will also have their therapeutic effect.

As a rule, a search for Cyanocobalamin analogues is carried out by a doctor if the patient has allergic reactions to the drug. Here is a list of Cyanocobalamin analogues:

• Vitamin B12 – liquid for injection;
• Medivitan;
• Neuromin;
• Triovit;
• Neurocobal;
• Neurovitan

All analogues of Cyanocobalamin are prescribed only by the attending physician. Each drug has its own dosage and regimen, so you cannot arbitrarily replace drugs prescribed by specialists.

Correct storage conditions for the drug

Cyanocobalamin must be stored in its original packaging, away from light and direct sunlight. The drug should not be frozen; the ideal storage temperature is from +15 to +25 degrees. Cyanocobalamin is valid for two years from the date of manufacture. The drug must not be used after the expiration date indicated on the packaging.

Price for Cyanocobalamin in pharmacies

Cyanocobalamin can be purchased at almost any pharmacy. A doctor's prescription is required to purchase the medicine. The cost of the drug in the form of an injection solution fluctuates around 30–40 rubles per pack of 10 ampoules. One ampoule of the drug costs 3–4 rubles, but, as a rule, the drug is sold only in packages of 10 ampoules. The dosage of the drug is 0.2 mg/ml or 0.5 mg/ml.

Some reviews about the drug Cyanocobalamin

Doctors often prescribe Cyanocobalamin as part of complex treatment. The drug is also used to boost immunity. Let's present several patient reviews about the drug.

Victoria, 32 years old. I was diagnosed with anemia. Doctors prescribed Cyanocobalamin injections every three days. After completing the treatment, I began to feel much better and felt a surge of strength and energy. Tests showed that the level of vitamin B12 in the body increased significantly. Now I take 1 injection of Cyanocobalamin once every two weeks for prevention and maintenance of the body. I was very pleased that the drug suited me completely, there were no side effects. And the price of this medicine is very affordable.

Maxim, 41 years old. The doctor prescribed me Cyanocobalamin injections to increase my hemoglobin levels. The drug was administered by injection 3 times a week, and then once a week. I tolerated the injections well, the drug did not cause any unpleasant symptoms or sensations. I was very pleased with the fact that after the course of the drug I felt a surge of strength and vigor.

Marina, 34 years old. I have been suffering from severe migraines for a long time. The disease is exhausting, not allowing me to feel like a person: I could neither rest nor work normally. During the examination, I was found to have a deficiency of vitamin B12, after which the doctor prescribed me Cyanocobalamin. The injections were done every day, after about a week the headaches began to subside and completely disappeared. Now I feel much better, I still continue to take Cyanocobalamin injections once a week. I am very happy and satisfied, Cyanocobalamin helped me get rid of a serious illness that brought me a lot of suffering and inconvenience. I tolerated the injections very well, the drug did not cause me any side effects.

There are contraindications. Specialist consultation required

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Cyanocobalamin is vitamin B12, which has a metabolic effect. In the body it turns into a coenzyme form - adenosylcobalamin, which is the active form of vitamin B12 and is part of numerous enzymes.

Cyanocobalamin belongs to the group of highly active biological water-soluble vitamins. It is necessary to ensure normal hematopoiesis, as it takes part in the formation of red blood cells and is necessary for their proper maturation.

Takes part in the transfer of methyl and hydrogen, participates in the formation of nucleic acids, and is also necessary in the synthesis of choline and creatine.

Cyanocobalamin is necessary for the accumulation of compounds that are found in red blood cells and contain sulfhydryl groups. Activates the blood coagulation system, in high doses causes an increase in thromboplastic activity and prothrombin activity.

Reduces the concentration of cholesterol in the blood. Has a beneficial effect on the function of the liver and nervous system. Increases the ability of tissues to regenerate.

Before prescribing Cyanocobalamin, its deficiency must be established diagnostically - it can mask a lack of folic acid.

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Price in pharmacies

Information about the price of Cyanocobalamin in Russian pharmacies is taken from online pharmacies and may differ slightly from the price in your region.

You can buy the drug in Moscow pharmacies at the price: Cyanocobalamin solution for injection 500 mcg/ml 1 ml 10 ampoules - from 23 rubles.

Dispensing conditions from pharmacies are by prescription.

Store out of reach of children and protected from light, at a temperature not exceeding 25 °C. Shelf life – 2 years.

A list of analogues is presented below.

What is Cyanocobalamin used for?

The drug Cyanocobalamin is prescribed in the following cases:

• conditions accompanied by vitamin B12 deficiency: chronic anemia associated with vitamin B12 deficiency - nutritional macrocytic anemia, Addison-Biermer disease; as part of combined treatment - posthemorrhagic, aplastic, iron deficiency anemia, as well as anemia caused by drugs and/or toxic substances;
• liver damage: as part of combination therapy - liver cirrhosis, liver failure, chronic hepatitis, alcoholism (prolonged fever);
• neurological diseases: neuralgia (including trigeminal neuralgia), radiculitis, polyneuritis, malnutrition, funicular myelosis, amyotrophic lateral sclerosis, peripheral nerve injuries, Down's disease, cerebral palsy;
• skin diseases: atopic dermatitis, photodermatosis, dermatitis herpetiformis, psoriasis.

For prevention purposes, it is used for the following conditions/diseases:

• taking para-aminosalicylic acid (PAS), biguanides, ascorbic acid in high doses;
• pathologies of the intestines and stomach leading to impaired absorption of vitamin B12 (malabsorption syndrome, Crohn's disease, sprue, resection of part of the stomach, small intestine);
• diarrhea, enteritis;
• radiation sickness.

Instructions for use Cyanocobalamin, doses and rules

Methods of using Cyanocobalamin solution (ampoules) - intramuscular, intralumbar, subcutaneous and intravenous.

For anemia associated with vitamin B12 deficiency, 100-200 mcg is administered every other day. For anemia with symptoms of funicular myelosis and for macrocytic anemia with diseases of the nervous system - 400-500 mcg daily in the first 7 days, then once every 5-7 days. During the period of remission in the absence of symptoms of funicular myelosis, the maintenance dose is 100 mcg \ 2 times a month, in the presence of neurological symptoms - 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 (especially in children) - 100 mcg until clinical improvement occurs. For nutritional anemia in young children and premature babies - 30 mcg per day for 15 days.

For diseases of the central and peripheral nervous system, neurological diseases with pain syndrome, it is administered in increasing doses - 200-500 mcg, if the condition improves - 100 mcg per day. The course of treatment is 2 weeks. For traumatic lesions of the peripheral nervous system, the instructions for use of Cyanocobalamin recommend dosages of 200-400 mcg every other day for 40-45 days.

For hepatitis and cirrhosis of the liver - 30-60 mcg per day or 100 mcg every other day for 25-40 days.

For dystrophies in young children, Down's disease and cerebral palsy, according to the instructions, 15-30 mcg of Cyanocobalamin is administered every other day.

For funicular myelosis and amyotrophic lateral sclerosis, Cyanocobalamin can be injected into the spinal canal at a dose of 15-30 mcg, gradually increasing the dose to 200-250 mcg.

For radiation sickness, diabetic neuropathy, sprue - 60-100 mcg daily for 20-30 days.

For vitamin B12 deficiency, for prevention - IM or IV 1 mg once a month; for treatment - 1 mg IM or IV daily for 1-2 weeks, maintenance dose 1-2 mg IM or IV - from 1 time per week to 1 time per month. The duration of treatment is determined individually.

Important information

Vitamin B12 deficiency should be confirmed diagnostically before prescribing the drug, as it may mask the 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.

If there is a tendency to form blood clots, Cyanocobalamin should be used in doses of up to 0.1 mg per administration.

Use during pregnancy and lactation

There is some evidence of a possible teratogenic effect on the fetus of large doses of B vitamins, and therefore Cyanocobalamin should not be used during pregnancy and breastfeeding.

Features of application

Before using the drug, read the sections of the instructions for use about contraindications, possible side effects and other important information.

Side effects Cyanocobalamin

Instructions for use warn of the possibility of side effects of the drug Cyanocobalamin:

• From the side of the central nervous system: rarely - a state of excitement.
• From the cardiovascular system: rarely - pain in the heart, tachycardia.
• Allergic reactions: rarely - urticaria.

Contraindications

The use of Cyanocobalamin is contraindicated for the following diseases or conditions:

• hypersensitivity to the components of the drug, cobalt;
• thromboembolism;
• erythremia;
• erythrocytosis;
• pregnancy and lactation period.

For malignant or benign tumors accompanied by a lack of vitamin B12 and megaloblastic anemia, as well as for angina pectoris, caution should be exercised in using the drug.

Overdose

Data on overdose are not provided.

List of Cyanocobalamin analogues

If it is necessary to replace the drug, there are two options - choosing another medication with the same active substance or a drug with a similar effect, but a different active substance. Drugs with similar effects are united by the same ATC code.

Cyanocobalamin analogues, list of drugs:

1. Cyanocobalamin bufus,
2. Cyanocobalamin-Vial,
3. Medivitan,
4. Neurovitan,
5. Cycomin-Altfarm.

When choosing a replacement, it is important to understand that the price, instructions for use and reviews of Cyanocobalamin do not apply to analogues. Before replacing, you must obtain the approval of your doctor and do not replace the drug yourself.

During treatment, patients must avoid driving all types of vehicles, and also refrain from performing work that requires quick response and increased attention.

Special information for healthcare workers

Interactions

When used simultaneously with hormonal contraceptives for oral administration, a decrease in the concentration of cyanocobalamin in the blood plasma is possible.

When used simultaneously with anticonvulsants, the absorption of cyanocobalamin from the intestine decreases.

When used simultaneously with neomycin, aminosalicylic acid, colchicine, cimetidine, ranitidine, and potassium preparations, the absorption of cyanocobalamin from the intestine decreases.

When administered parenterally, chloramphenicol may reduce the hematopoietic effect of cyanocobalamin in anemia.

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).

At the beginning of treatment for megaloblastic anemia, cases of arrhythmia secondary to hypokalemia have been reported, as a result of which it is necessary to monitor the potassium concentration during this period.

When using Cyanocobalamin in elderly patients, no adverse reactions other than those indicated above were observed.