Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.
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.
Take oral cyanocobalamin with a full glass of water.
The sublingual tablet should be placed under your tongue where it will dissolve.
Do not crush, chew, or break an extended-release tablet. Swallow it whole.
To be sure cyanocobalamin is helping your condition, your blood will need to be tested every 3 to 6 months. This will help your doctor determine the correct dose and how long to treat you with cyanocobalamin.
To treat pernicious anemia, you will have to use this medication 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.
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What is the most important information I should know about oral B-12 (cyanocobalamin)?
You should not use this medicine if you have Leber's disease. Cyanocobalamin can lead to optic nerve damage (and possibly blindness) in people with Leber's disease.
What should I discuss with my healthcare provider before taking oral B-12 (cyanocobalamin)?
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.
To make sure cyanocobalamin is safe for you, tell your doctor if you have:
any type of infection;
iron or folic acid deficiency;
kidney or liver disease; or
if you are receiving any medication or treatment that affects bone marrow.
It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
Cyanocobalamin can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
Usual Adult Dose for Pernicious Anemia
Initial dose: 1000 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.
Cyanocobalamin Pregnancy Warnings
This drug should not be used during pregnancy unless the benefit outweighs the risk to the fetus. (AU) AU TGA pregnancy category: Exempt US FDA pregnancy category: C Comments: -Vitamin B12 needs are increased in pregnancy. -Megaloblastic anemia of pregnancy is usually due to folic acid deficiency. -Do not use for megaloblastic anemia of pregnancy due to folic acid deficiency.