cyanocobalamin

You should not use this medication 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.

Before using cyanocobalamin, tell your doctor if you have:

• any type of infection;

• kidney or liver disease; or

• if you are receiving any medication or treatment that affects bone marrow.

If you are using the nasal spray, tell your doctor if you develop nasal congestion, a cold, or allergies. The nasal spray may not work as well if you are congested.

FDA pregnancy category C. It is not known whether this medication can harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Cyanocobalamin passes into breast milk, but it is not known whether cyanocobalamin could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Use this medication exactly as prescribed by your doctor. Do not use it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Cyanocobalamin comes in oral tablets, sublingual tablets, nasal gel, nasal spray, and an injection form.

Take the oral tablet with a full glass of water.

The sublingual tablet should be placed under the tongue where it will dissolve.

The injection form is given as a shot into a muscle or under the skin. Your doctor, nurse, or other healthcare provider will give you this injection. You may be shown how to inject your medicine at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes.

To use the nasal forms:

• Gently blow your nose to clear any mucous.

• Prime the nasal gel pump before your first use and whenever it has been longer than 2 days between uses. Pump the gel unit several times until a gel droplet appears at the tip, then pump 2 more times.

• Prime the nasal spray before your first use by pumping the spray a few times until a fine mist appears. If it has been longer than 5 days between uses, pump 2 priming sprays before use.

• Insert the tip of the nasal pump about half an inch into your nostril, pointing it towards the back of the nose.

• Gently press your other nostril closed with your finger, and tilt your head forward. Pump and sniff gently at the same time. Return your head to an upright position.

• Remove the pump from your nose. Rub your nostril gently for a few seconds.

• Clean the tip of the spray or gel pump with a clean tissue and recap.

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.

To be sure this medication is helping your condition, your blood will need to be tested often. This will help your doctor determine how long to treat you with cyanocobalamin. Do not miss any scheduled appointments.

Store this medication at room temperature away from moisture, heat, and light. Keep the nasal gel in the prescription vial when not in use.

Use the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up the missed dose.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using cyanocobalamin and call your doctor at once if you have any of these serious side effects:

• chest pain or difficulty breathing; or

• unusual warmth, redness, or pain in an arm or leg.

Less serious side effects may include:

• headache or dizziness;

• upset stomach or diarrhea;

• numbness or tingling;

• fever;

• joint pain;

• stuffy or runny nose, sore throat, nasal pain;

• swelling; or

• itching or rash.

This list is not complete and other side effects may occur. Tell your doctor about any unusual or bothersome side effect.

You should not use this medication 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 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.

Avoid eating or drinking hot foods or liquids within 1 hour before or after using the nasal form of this medication.

Avoid eating or drinking hot foods or liquids within 1 hour before or after using the nasal form of this medication.

Do not use any other nasal medications while using cyanocobalamin nasal unless they are approved by your doctor.

Before using cyanocobalamin, tell your doctor if you are taking any of the following medications:

• antibiotics;

• methotrexate (Rheumatrex);

• pyrimethamine (Daraprim);

• colchicine; or

• if you drank a lot of alcohol within the past 2 weeks.

This list is not complete and there may be other drugs that can interact with cyanocobalamin. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of cyanocobalamin is not likely to cause life-threatening symptoms.