Medically reviewed on Jul 16, 2018
What is oral cyanocobalamin?
Cyanocobalamin is a man-made form of vitamin B12. Vitamin B12 is important for growth, cell reproduction, blood formation, and protein and tissue synthesis.
Cyanocobalamin may also be used for purposes not listed in this medication guide.
You should not use cyanocobalamin if you are allergic to cobalt, or if you have Leber's disease.
Before taking this medicine
You should not use this medicine if you are allergic to cobalt, or if you have Leber's disease. Cyanocobalamin can lead to optic nerve damage (and possibly blindness) in people with Leber's disease.
Tell your doctor if you have ever had:
a bleeding or blood clotting disorder;
an iron or folic acid deficiency;
low levels of potassium in your blood; or
an intestinal disorder such as ulcerative colitis.
Tell your doctor if you are pregnant or breast-feeding.
Do not give this medicine to a child without medical advice.
How should I take oral cyanocobalamin?
Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.
Carefully follow instructions about whether to take your cyanocobalamin with or without food.
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.
Do not swallow a lozenge or sublingual tablet whole. Allow it to dissolve in your mouth without chewing. The sublingual tablet should be placed under your tongue.
Do not crush, chew, or break an extended-release tablet. Swallow it whole with a full glass of water.
You may need frequent medical tests to help your doctor determine how long to treat you with cyanocobalamin.
To treat pernicious anemia, you will have to use cyanocobalamin 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. Take all of your medications as directed.
Store at room temperature away from moisture, heat, and light.
What happens if I miss a dose?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking oral cyanocobalamin?
Avoid drinking large amounts of alcohol. Heavy drinking can make it harder for your body to absorb cyanocobalamin.
Oral cyanocobalamin side effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
shortness of breath (even with mild exertion), swelling, rapid weight gain;
cough, chest pain; or
Common side effects may include diarrhea.
numbness or tingling;
swollen tongue; or
itching or rash.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
Cyanocobalamin dosing information
Usual Adult Dose for Pernicious Anemia:
Initial dose: 100 mcg intramuscularly or deep subcutaneous once a day for 6 to 7 days
If clinical improvement and reticulocyte response is seen from the above dosing:
-100 mcg every other day for 7 doses, then:
-100 mcg every 3 to 4 days for 2 to 3 weeks, then:
Maintenance dose: 100 to 1000 mcg monthly
Duration of therapy: Life
-Administer concomitant folic acid if needed.
-Chronic treatment should be done with an oral preparation in patients with normal intestinal absorption.
Usual Adult Dose for B12 Nutritional Deficiency:
25 to 2000 mcg orally daily
Usual Adult Dose for Schilling Test:
1000 mcg intramuscularly is the flushing dose
Usual Pediatric Dose for B12 Nutritional Deficiency:
0.5 to 3 mcg daily
What other drugs will affect oral cyanocobalamin?
Tell your doctor about all your other medicines, especially:
drugs that weaken the immune system such as cancer medicine, or steroids;
oral diabetes medicine that contains metformin; or
This list is not complete. Other drugs may affect cyanocobalamin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
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.
Copyright 1996-2018 Cerner Multum, Inc. Version: 7.01.
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