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Cyanocobalamin Disease Interactions

There are 4 disease interactions with cyanocobalamin.

Major

Cyano-/hydroxocobalamin (vit B12) (applies to cyanocobalamin) hypokalemia

Major Potential Hazard, High plausibility.

Hypokalemia (resulting in death) has occurred during vitamin B12 therapy as a result of increased red blood cell requirements during hematopoiesis. Clinical monitoring and correction of potassium levels prior to and during vitamin B12 therapy is necessary.

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Major

Cyano-/hydroxocobalamin (vit B12) (applies to cyanocobalamin) optic nerve

Major Potential Hazard, High plausibility. Applicable conditions: Leber's Disease

The use of cyanocobalamin is contraindicated in patients with Leber's disease (hereditary optic nerve atrophy). Cyanocobalamin has induced severe and rapid optic nerve atrophy in patient's with early Leber's disease.

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Moderate

Cyano-/hydroxocobalamin (vit B12) (applies to cyanocobalamin) malabsorption

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Malabsorption Syndrome

Absorption of vitamin B12 is decreased in malabsorption syndromes and in pernicious anemia without coadministration of intrinsic factor (IF). Cyanocobalamin is rapidly absorbed following IM or subcutaneous injections. Hydroxocobalamin (cyanocobalamin analog) functions the same a cyanocobalamin, but has induced antibody formation to the hydroxocobalamin-transcobalamin II complex. The use of cyanocobalamin may be preferred in patients with these conditions.

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Moderate

Cyanocobalamin (applies to cyanocobalamin) renal impairment

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Renal Dysfunction

Cyanocobalamin products contain aluminum that may be toxic and may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and other solutions which also contain aluminum. Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum greater than 4-5 mcg/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity. Caution and monitoring are recommended.

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Cyanocobalamin drug interactions

There are 15 drug interactions with cyanocobalamin.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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