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hydroxocobalamin (Intravenous route)

hye-drox-oh-koe-BAL-a-min

Commonly used brand name(s)

In the U.S.

  • Cyanokit

Available Dosage Forms:

  • Powder for Solution

Therapeutic Class: Cyanide Antidote

Pharmacologic Class: Vitamin B (class)

Uses For hydroxocobalamin

Hydroxocobalamin injection is an emergency treatment (antidote) used in patients with known or suspected cyanide poisoning. Cyanide poisoning is a life-threatening condition that requires immediate medical attention. It is more likely to occur if you breathe smoke from closed-space household and industrial fires, or you have swallowed or breathe cyanide (a chemical poison), or your skin is exposed to cyanide. Signs and symptoms include chest tightness, confusion, dilated or enlarged pupils, nausea or vomiting, rapid or shallow breathing, trouble breathing, or seizures.

hydroxocobalamin is to be given only by or under the direct supervision of a doctor.

Before Using hydroxocobalamin

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For hydroxocobalamin, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to hydroxocobalamin or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of hydroxocobalamin injection in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of hydroxocobalamin injection in the elderly.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of hydroxocobalamin. Make sure you tell your doctor if you have any other medical problems, especially:

  • Allergy to cyanocobalamin or hydroxocobalamin—Use with caution.
  • Hypertension (high blood pressure) or
  • Hypotension (low blood pressure)—Use with caution. May make these conditions worse.

Proper Use of hydroxocobalamin

A doctor or an emergency care provider will give you hydroxocobalamin. hydroxocobalamin is given through a needle placed in one of your veins for 15 minutes.

hydroxocobalamin comes with a patient information insert. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.

Precautions While Using hydroxocobalamin

Your doctor will check your progress closely while you are receiving hydroxocobalamin. This will allow your doctor to see if the medicine is working properly. Blood tests will also be needed to check for unwanted effects.

hydroxocobalamin may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a rash, itching, chest tightness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using hydroxocobalamin.

hydroxocobalamin may cause high or low blood pressure. Tell your doctor right away if you have fast, slow, pounding, or uneven heartbeats while receiving hydroxocobalamin.

hydroxocobalamin may cause skin redness and make your skin more sensitive to sunlight. This effect may last for up to 2 weeks after you have received hydroxocobalamin. Avoid being in the sun while your skin is red. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds.

hydroxocobalamin may cause an acne-like rash that appears 7 to 28 days after treatment. This rash will disappear within a few weeks.

hydroxocobalamin Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common
  • Blurred vision
  • dizziness
  • headache
  • nervousness
  • pounding in the ears
  • redness of the skin
  • slow or fast heartbeat
Incidence not known
  • Bloating or swelling of the face, arms, hands, lower legs, or feet
  • cough
  • difficult or labored breathing
  • difficulty with swallowing
  • feeling of warmth
  • hives or welts, itching, or skin rash
  • large, hive-like swelling on the , eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • rapid weight gain
  • redness of the face, neck, arms, and occasionally, upper chest
  • sudden sweating
  • tightness in the chest
  • tingling of the hands or feet
  • unusual tiredness or weakness
  • unusual weight gain or loss

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Blemishes on the skin
  • dry, red, hot, or irritated skin
  • nausea
  • pimples
  • red colored urine
Incidence not known
  • Acid or sour stomach
  • being forgetful
  • belching
  • diarrhea
  • heartburn
  • indigestion
  • redness or swelling of the eyes
  • restlessness
  • stomach discomfort, upset, or pain

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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