Cynomin Injection
Cyanocobalamin (Vitamin B12)
250mcg/ml
Jayson Pharmaceuticals Ltd.
| Pack size | 10's Pack |
|---|---|
| Dispensing mode | |
| Source | |
| Agent | |
| Retail Price | 4.51 AED |
Available as:
Indications
Cynomin Injection is used for:
Pernicious anemia, Vitamin B12 deficiency due to low intake from food, Thyrotoxicosis, Hemorrhage, Malignancy, Liver or kidney disease, Gastric bypass surgery, Total or partial gastrectomy, Gluten enteropathy or sprue, Folic acid deficiency, Macrocytic anaemia
Adult Dose
Intramuscular
Pernicious or macrocytic anemia
Adult: 250-1000 mcg, given on alternate days for 1-2 weeks, then 250 mcg weekly until the blood count returns to normal.
Maintenance doses: 1000 mcg, given every month.
Alternative parenteral dosing:
Intramuscular/Subcutaneously
100 mcg IM/SC once daily for 6-7 days, then every other day for 7 doses, then every 3-4 days for 2-3 weeks, then monthly
OR 1000 mcg IM/SC once daily for 7 days, then weekly for 1 month, then monthly
Intramuscular
B12 Deficiency
Initial: 30 mcg IM once daily for 5-10 days
Maintenance: 100-200 mcg IM monthly
Child Dose
Renal Dose
Renal impairment: Increased requirement in renal impairment.
Administration
Contra Indications
Leber's disease, tobacco amblyopia.
Precautions
Intensive treatment of B12-deficient megaloblastic anemia may cause hypokalemia and sudden death; monitor serum potassium and platelet counts more frequently in these patients
Nasal disease; defer use until symptoms resolve
Injection is incompatible with some common drugs (eg, warfarin and several phenothiazines) but is compatible with vitamins B and C
Vitamin B12 deficiency for >3 months results in irreversible degenerative CNS lesions
Thrombocytosis may occur with treatment of severe vitamin B12 megaloblastic anemia
Oral and intranasal route are not indicated for the treatment of pernicious anemia until symptoms resolve
Vitamin B12 deficiency masks signs of polycythemia vera; vitamin B12 administration may unmask condition; patients exhibiting clinical or hematologic response consistent with polycythemia vera should be referred for further evaluation
IM and SC route used to treat pernicious anemia; oral and intranasal not indicated until hematologic remission and no signs of nervous system involvement
Parenteral product may contain aluminum; toxic aluminum concentrations may occur with renal dysfunction, high doses, or prolonged use
Efficacy of intranasal administration in patients with nasal pathology or concomitant therapy has not been determined; use with caution
Cyanocobalamin products, not recommended for use in patients with Leber’s optic atrophy; for patients with Leber’s disease requiring vitamin B12, consider alternative therapy (eg, hydroxocobalamin) for B12 supplementation; severe and swift optic atrophy reported in patients with early Leber’s disease (hereditary optic nerve atrophy) treated with vitamin B12
Anaphylactic shock and death reported after parenteral vitamin B12 administration; if patients are to start nasal spray before having tolerated cyanocobalamin parenterally, consider administering an intradermal test doseof parenteral vitamin B12 to patients suspected of cyanocobalamin hypersensitivity
Pregnancy-Lactation
Pregnancy
Administration of approved recommended dose is not expected to cause major birth defects, miscarriage or adverse maternal or fetal outcomes
There are risks associated with vitamin B12 deficiency during pregnancy; severe maternal vitamin B12 deficiency during pregnancy may result in adverse pregnancy outcomes such as low birth weight, preterm birth and megaloblastic anemia
Lactation
Vitamin B12 is present in human milk; administration of approved recommended dose is not expected to cause harm to a breastfed child; there is no information on effects the breastfed child or on milk production; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for drug and any potential adverse effects on breastfed infant from underlying maternal condition
Interactions
Absorption reduced by antibiotics, aminosalicylic acid, anticonvulsants, biguanides, cholestyramine, cimetidine, colchicine, K salts, methyldopa.
Adverse Effects
Side effects of Cyanocobalamin (Vitamin B12) :
>10%
Arthralgia (12%),Dizziness (12%),Headache (12%),Nasopharyngitis (12%)
Frequency Not Defined
Anaphylaxis,Angioedema,Congestive heart failure,Peripheral vascular disease,Pulmonary edema,Diarrhea,Dyspepsia,Polycythemia vera,Sore throat,Nervousness,Rhinitis,Glossitis,Hypoesthesia
Mechanism of Action
Vitamin B12 (cyanocobalamin): Required for the maintenance of normal erthropoiesis, nucleprotein and myelin synthesis, cell reproduction and normal growth; Coenzyme; metabolic functions include protein synthesis and carbohydrate metabolism. Plays role in cell replication and hematopoiesis.
Note
Cynomin 250mcg/ml Injection manufactured by Jayson Pharmaceuticals Ltd.. Its generic name is Cyanocobalamin (Vitamin B12). Cynomin is availble in Bangladesh.
Farmaco BD drug index information on Cynomin Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.