Cyanocobalamin Injection

Overview of Cyanocobalamin Injection

Dosage Strength

2,000 mcg/mL 5 mL Vial
2,000 mcg/mL 30 mL Vial

General Information

A vitamin from the B-complex family known as cobalamins, cyanocobalamin is one of them (corrinoids). It is a synthetic or artificial form of vitamin B12 that is sold both on the market and by prescription. There are various more chemical types of cobalamins, such as hydroxocobalamin, methylcobalamin, and adenosylcobalamin. 12 The most prevalent type of cobalamin found in dietary supplements and meals with added nutrients is cyanocobalamin. It is more stable than other forms of vitamin B12 because it has a cyano (cyanide) group in its structure, which prevents the molecule from degrading. However, because hydroxycobalamin is the form of vitamin B12 that is the most physiologically active, it is preferred over cyanocobalamin for the treatment of vitamin B12 deficiency.1234

Foods do not normally contain cyanocobalamin because cyanide, which is not in the vitamin’s natural form, is present. The uncommon mineral cobalt (4.34 percent) is a component of cyanocobalamin’s chemical structure and is responsible for binding the cyano group to a corrin ring in the middle of the compound. 5 Bacterial fermentation is used in the commercial production of the vitamin. It is more air-stable and easier to crystallize than other forms of vitamin B12. 3 Orthorhombic needles, red crystals, or a dark red, amorphous or crystalline powder are the most common forms of cyanocobalamin. The substance is extremely hygroscopic in its anhydrous state. If exposed to air, it may absorb up to 12% of water. Cyanocobalamin is insoluble in chloroform, acetone, and ether but only sporadically soluble in alcohol and water (1 in 80 of water). This vitamin’s coenzymes are very light-sensitive. 6

There are numerous dosing forms for cyanocobalamin, including tablets, nasal spray, and injectable. The medication was first given approval by the US-FDA in 1942. 7 But in the early 1950s, the drug became widely accessible for regular usage in the management of B12 insufficiency. 8

References

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6.Sweetman SC, editor. Martindale: the complete drug reference, 34th ed. London: Pharmaceutical press; 2014.
7.CaloMist™ Nasal Spray (cyanocobalamin, USP) label. 2007. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/022102s000lbl.pdf [Accessed October 23, 2020].
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11.Berney M, Berney-Meyer L, Wong KW, Chen B, Chen M, Kim J, Wang J, Harris D, Parkhill J, Chan J, Wang F. Essential roles of methionine and S-adenosylmethionine in the autarkic lifestyle of Mycobacterium tuberculosis. Proceedings of the National Academy of Sciences. 2015; 112: 10008-10013.
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13.Sanz-Cuesta T, González-Escobar P, Riesgo-Fuertes R, Garrido-Elustondo S, del Cura-González I, Martín-Fernández J, Escortell-Mayor E, Rodríguez-Salvanés F, García-Solano M, González-González R, Martín-de la Sierra MÁ. Oral versus intramuscular administration of vitamin B12 for the treatment of patients with vitamin B12 deficiency: a pragmatic, randomised, multicentre, non-inferiority clinical trial undertaken in the primary healthcare setting (Project OB12). BMC Public Health. 2012; 12:1-1.
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15.CYANOCOBALAMIN INJECTION, USP 1000 mcg/mL Sterile (Vitamin B12) [Label]. 2014. Available from: https://pdf.hres.ca/dpd_pm/00026115.PDF [Accessed October 26, 2020].
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20.Nascobal® (Cyanocobalamin, USP) Nasal Spray 500 mcg/spray 0.125 mL [Label]. 2014. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/021642s020lbl.pdf [Accessed October 26, 2020].
21.Caballero MR, Lukawska J, Lee TH, Dugué P. Allergy to vitamin B12: two cases of successful desensitization with cyanocobalamin. Allergy. 2007; 62: 1341-1342.
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