CaloMist

Generic Name: cyanocobalamin (nasal spray) (sye AN oh koe BAL a min)
Brand Names: CaloMist

What is CaloMist?

CaloMist is a nasal spray containing 25 mcg cyanocobalamin, USP /0.1 mL

Cyanocobalamin is a man-made form of vitamin B12. Vitamin B12 is important for growth, cell reproduction, blood formation, and protein and tissue synthesis.

CaloMist is used to treat vitamin B12 deficiency in people with pernicious anemia and other conditions.

CaloMist may also be used for other purposes not listed in this medication guide.

Important information

You should not use CaloMist if you are allergic to cobalt, or if you have Leber's disease. CaloMist can lead to optic nerve damage (and possibly blindness) in people with Leber's disease.

To treat pernicious anemia, you will have to use CaloMist on a regular basis for the rest of your life. Not using the medication can lead to irreversible nerve damage in your spinal cord.

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Pernicious anemia is also treated with folic acid to help maintain red blood cells. However, folic acid will not treat Vitamin B12 deficiency and will not prevent possible damage to the spinal cord. Use all of your medications as directed.

Avoid eating or drinking hot foods or liquids within 1 hour before or after using CaloMist.

Tell your doctor if you develop nasal congestion, a cold, or allergies. The nasal spray may not work as well if you are congested.

Your dose needs may change if you become pregnant, if you breast-feed, or if you eat a vegetarian diet. Tell your doctor about any changes in your diet or medical condition.

Before using CaloMist

You should not use CaloMist if you are allergic to cobalt, or if you have Leber's disease. CaloMist can lead to optic nerve damage (and possibly blindness) in people with Leber's disease.

Before using CaloMist, tell your doctor if you have:

  • any type of infection;

  • iron or folic acid deficiency;

  • kidney or liver disease; or

  • if you are receiving any medication or treatment that affects bone marrow.

Tell your doctor if you develop nasal congestion, a cold, or allergies. CaloMist may not work as well if your nose is congested.

FDA pregnancy category C. It is not known whether this medication can harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. CaloMist passes into breast milk, but it is not known whether CaloMist could harm a nursing baby. Do not use CaloMist without telling your doctor if you are breast-feeding a baby.

How should I use CaloMist?

Use CaloMist exactly as prescribed by your doctor. Do not use it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Your dose needs may change if you become pregnant, if you breast-feed, or if you eat a vegetarian diet. Tell your doctor about any changes in your diet or medical condition.

To use CaloMist.

  • Gently blow your nose to clear any mucus.

  • The pump must be primed before the bottle is used for the first time. To prime the pump, place the nozzle between the first and second finger with the thumb on the bottom of the bottle. Pump the unit firmly and quickly then repeat this priming an additional 6 times for a total of 7 priming sprays. Now the nasal spray is ready for first-time use. If 5 or more days elapse since last use, the pump must be re-primed with two re-priming sprays.

  • Insert the tip of the nasal pump about half an inch into your nostril, pointing it toward the back of the nose.

  • Gently press your other nostril closed with your finger, and tilt your head forward. Pump and sniff gently at the same time. Return your head to an upright position.

  • Remove the pump from your nose. Rub your nostril gently for a few seconds.

  • Clean the tip of the spray pump with a clean tissue and recap.

To be sure CaloMist is helping your condition, your blood will need to be tested every 3 to 6 months. This will help your doctor determine the correct dose and how long to treat you with CaloMist. Do not miss any scheduled appointments.

To treat pernicious anemia, you will have to use CaloMist on a regular basis for the rest of your life. Not using the medication can lead to irreversible nerve damage in your spinal cord.

Pernicious anemia is also treated with folic acid to help maintain red blood cells. However, folic acid will not treat Vitamin B12 deficiency and will not prevent possible damage to the spinal cord. Use all of your medications as directed.

Store CaloMist at room temperature away from moisture, heat, and light. Store the nasal spray upright.

What happens if I miss a dose?

Use the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of CaloMist is not likely to cause life-threatening symptoms.

What should I avoid?

Do not drink hot liquid or eat hot food within 1 hour before or after you use CaloMist.

Avoid drinking large amounts of alcohol while you are being treated with CaloMist.

Avoid using any other nasal medications that your doctor has not recommended or prescribed.

CaloMist side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:
  • chest pain;

  • feeling short of breath, even with mild exertion;

  • swelling, rapid weight gain; or

  • unusual warmth, redness, or pain in an arm or leg.

Less serious side effects may include:

  • headache, dizziness, weakness;

  • nausea, upset stomach, diarrhea;

  • numbness or tingling;

  • runny nose, sneezing, sore throat, swollen tongue;

  • fever;

  • joint pain; or

  • itching or rash.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect CaloMist?

Before using CaloMist, tell your doctor if you are taking any of the following medications:

  • antibiotics;

  • methotrexate (Rheumatrex);

  • pyrimethamine (Daraprim);

  • colchicine; or

  • if you drank a lot of alcohol within the past 2 weeks.

This list is not complete and there may be other drugs that can interact with CaloMist. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about CaloMist.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use CaloMist only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2014 Cerner Multum, Inc. Version: 1.03. Revision Date: 4/12/2009 4:37:26 PM.
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