Nascobal

Generic Name: cyanocobalamin nasal (sigh ah no ko BALL ah min)
Brand Name: Nascobal

What is Nascobal (cyanocobalamin nasal)?

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

Cyanocobalamin nasal is used to maintain vitamin B12 levels in patients with pernicious anemia, nutritional vitamin B12 deficiency, malabsorption of vitamin B12, and other cases of vitamin B12 deficiency.

Cyanocobalamin nasal may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Nascobal (cyanocobalamin nasal)?

To treat pernicious anemia, you will have to use this medication on a regular basis for the rest of your life. Failure to do this will result in irreversible damage to the nerves of your spinal cord. Also, treatment with cyanocobalamin nasal cannot be substituted with folic acid therapy. Folic acid may prevent anemia but it will allow progressive damage to the spinal cord.

Slideshow: View Frightful (But Dead Serious) Drug Side Effects

Use the nasal spray one hour before or after eating or drinking hot foods or liquids.

Who should not use Nascobal (cyanocobalamin nasal)?

Before using this medication, tell your doctor if you have Leber's disease. Cyanocobalamin nasal may lead to optic nerve damage and possibly blindness when used by people with this condition.

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

Cyanocobalamin nasal is in the FDA pregnancy category C. This means that it is not known whether cyanocobalamin nasal will harm an unborn baby. Vitamin B12 is important to the proper development of a baby. Talk to your doctor about using this medication if you are pregnant.

Cyanocobalamin nasal passes into breast milk. Vitamin B12 is necessary for both mother and child during breast-feeding. Talk to your doctor about using this medication during breast-feeding.

How should I use Nascobal (cyanocobalamin nasal)?

Use cyanocobalamin nasal exactly as directed by your doctor. If you do not understand these directions, ask your doctor, nurse, or pharmacist to explain them to you.

To use the nasal gel:

  • Gently blow your nose to clear any mucous.

  • Uncap the pump. Prime the unit (on first use and after 48 hours without use) by pumping it seven to eight times until a gel droplet appears at the tip. Then prime the unit with an additional two sprays.

  • Insert the tip about 1 centimeter (one-third inch) into your nostril, pointing it towards the back of the nose.

  • Block your other nostril and tilt your head forward.

  • Pump and sniff gently at the same time.

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

  • Clean the pump nozzle with a tissue and recap.

Use only one dose in one nostril unless otherwise directed. The nasal gel is usually used once a week to treat pernicious anemia.

Use the nasal spray 1 hour before or after eating or drinking hot foods or liquids.

To treat pernicious anemia, you will have to use this medication on a regular basis for the rest of your life. Failure to do so will result in irreversible damage to the nerves of your spinal cord. Also, treatment with cyanocobalamin nasal cannot be replaced with folic acid therapy. Folic acid may prevent anemia, but it will allow progressive damage to the spinal cord.

Store this medication at room temperature away from moisture, heat, and light. Keep the nasal gel in the prescription vial when it is not in use.

What happens if I miss a dose?

Use the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the dose you missed and use only your next regularly scheduled dose. Do not use a double dose of this medication unless otherwise directed by your doctor.

What happens if I overdose?

An overdose of cyanocobalamin nasal is unlikely to threaten life. If you suspect an overdose, call your doctor, an emergency room, or a poison control center for advice.

Symptoms of a cyanocobalamin nasal overdose are not known.

What should I avoid while using Nascobal (cyanocobalamin nasal)?

Use the nasal spray 1 hour before or after eating or drinking hot foods or liquids.

Do not use any other nasal medications while using cyanocobalamin nasal unless they are approved by your doctor.

Nascobal (cyanocobalamin nasal) side effects

If you experience an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives), stop using cyanocobalamin nasal and seek emergency medical attention:

Other, less serious side effects may be more likely to occur. Continue to use cyanocobalamin nasal and talk to your doctor if you experience

  • headache;

  • runny nose;

  • upset stomach; or

  • numbness or tingling.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

See also: Side effects (in more detail)

What other drugs will affect Nascobal (cyanocobalamin nasal)?

Do not use any other nasal medications while using cyanocobalamin nasal unless they are approved by your doctor.

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

  • antibiotics, methotrexate (Rheumatrex), or pyrimethamine (Daraprim). These medicines may interfere with diagnostic tests for vitamin B12 and folic acid.

  • colchicine, or alcohol used heavily for 2 weeks or longer. These drugs can decrease the absorption of cyanocobalamin nasal.

Drugs other than those listed here may also interact with cyanocobalamin nasal. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

  • Your pharmacist has additional information about cyanocobalamin nasal written for health professionals that you may read.

What does my medication look like?

Cyanocobalamin nasalis available with a prescription under the brand name Nascobal in a 500 mcg/spray nasal gel. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication 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 1996-2012 Cerner Multum, Inc. Version: 1.03. Revision Date: 2/13/04 4:07:26 PM.

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