Medication Guide App

Nascobal spray

Generic Name: cyanocobalamin (b12) (SYE-an-oh-koe-BAL-a-min)
Brand Name: Nascobal

Nascobal spray is used for:

Maintaining normal vitamin B12 blood levels in certain patients with pernicious anemia. It is also used to treat or prevent low blood levels of vitamin B12 that may be caused by other conditions.

Nascobal spray is a form of vitamin B12. It works by replacing vitamin B12 in the body.

Do NOT use Nascobal spray if:

  • you are allergic to any ingredient in Nascobal spray, including cobalt

Contact your doctor or health care provider right away if any of these apply to you.

Slideshow: Doctor Avoidance: 5 Reasons Why It's Not a Good Idea

Before using Nascobal spray:

Some medical conditions may interact with Nascobal spray. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a runny or stuffy nose, or an upper respiratory tract infection
  • if you have any type of anemia, bone marrow problems, certain eye nerve problems (Leber disease), an infection, a buildup of waste in the blood (uremia), or low blood iron or folic acid levels
  • if you are a vegetarian
  • if you drink alcohol on a regular basis

Some MEDICINES MAY INTERACT with Nascobal spray. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Chloramphenicol, colchicine, or para-aminosalicylic acid because they may decrease Nascobal spray's effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if Nascobal spray may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Nascobal spray:

Use Nascobal spray as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • An extra patient leaflet is available with Nascobal spray. Talk to your pharmacist if you have questions about this information.
  • Nascobal spray is used in the nose.
  • Follow the directions provided by your doctor or other health care provider. If you are unsure how to use Nascobal spray, contact your doctor or other health care provider.
  • Do not use Nascobal spray within 1 hour before or after eating or drinking hot foods or liquids.
  • Prime the pump before the first use. Place the nozzle between the first and second finger with the thumb on the bottom. Point the nozzle away from yourself and others. Pump the unit firmly and quickly until the medicine sprays out, then spray two more times.
  • Re-prime the pump before each dose. Point the nozzle away from yourself and others, then spray once.
  • Use Nascobal spray in only 1 nostril each week.
  • To use Nascobal spray, sit down and tilt your head back slightly. Place the tip of the spray container into the nose. Using a finger from your other hand, press against the opposite nostril to close it off. Breath gently through the open nostril and spray a dose of medicine from the container. After using the medicine, rinse the tip of the spray unit in hot water and dry with a clean tissue to prevent contamination.
  • Nascobal spray is usually used 1 time per week. Do not use it more often than 1 time per week without checking with your doctor.
  • This bottle contains 8 doses. Do not continue to use this bottle after 8 doses have been used. It may not give the correct amount of medicine.
  • Continue to use Nascobal spray even if you feel well. Do not miss any doses.
  • If you miss a dose of Nascobal spray, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Nascobal spray.

Important safety information:

  • Heavy alcohol intake for more than 2 weeks may decrease the effectiveness of Nascobal spray. Check with your doctor if you drink alcohol on a regular basis.
  • Do not substitute folic acid for Nascobal spray without first checking with your doctor. Folic acid may prevent anemia but may not prevent other serious effects such as spinal cord problems.
  • Certain medicines, including antibiotics, methotrexate, or pyrimethamine, may interfere with lab tests for vitamin B12 and folic acid. Be sure your doctor and lab personnel know all the medicines that you are taking.
  • Do not take large doses of vitamins while taking Nascobal spray unless your doctor tells you to.
  • Lab tests, including complete blood cell counts; platelet counts; blood potassium; and blood vitamin B12, iron, and folic acid levels, may be performed while you use Nascobal spray. These tests may be used to monitor your condition or check for side effects. They may be performed every 3 to 6 months. Be sure to keep all doctor and lab appointments.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant while taking Nascobal spray, check with your doctor. You will need to discuss the benefits and risks of using Nascobal spray while you are pregnant. Nascobal spray is found in breast milk. If you are or will be breast-feeding while you are using Nascobal spray, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Nascobal spray:

All medicines may cause side effects, but many people have no, or minor, side effects. When used in small doses, no COMMON side effects have been reported with this product. Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); calf swelling or tenderness; chest pain; irregular heartbeat; muscle weakness or cramping; shortness of breath; swelling of the hands, ankles, or feet; unusual bruising.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of Nascobal spray:

Store Nascobal spray at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Store upright. Do not freeze. Do not store in the bathroom. Keep Nascobal spray out of the reach of children and away from pets.

General information:

  • If you have any questions about Nascobal spray, please talk with your doctor, pharmacist, or other health care provider.
  • Nascobal spray is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take Nascobal spray or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Nascobal spray. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Nascobal spray. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using Nascobal spray.

Issue Date: September 3, 2014
Database Edition 14.3.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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