Indications for use
Chronic anemia that occurs with vitamin B12 deficiency (Addison-Birmer’s disease, alimentary macrocytic anemia), as part of a complex treatment of anemia (in
Skin diseases (psoriasis, photodermatosis, dermatitis herpetiformis, atopic dermatitis).
For prophylactic purposes, when prescribing biguanides, PAS, high-dose ascorbic acid, pathologies of the stomach and intestines with absorption of vitamin B12 (resection of a part of the stomach, small intestine, Crohn’s disease, celiac disease, malabsorption syndrome, sprue), malignant pancreatic and intestinal , radiation sickness.
Stress and infection (long-lasting), diet, pathology of the kidneys.
Possible analogues (substitutes)
Active ingredient, group
Contraindications to the use of Vitamin B12 are: hypersensitivity, thromboembolism, erythremia, erythrocytosis, pregnancy (there are some indications of the possible teratogenic effect of B vitamins in high doses), the lactation period.
It is used with caution in case of stenocardia, benign and malignant neoplasms, accompanied by megaloblastic anemia and vitamin B12 deficiency, with a tendency to form blood clots.
How to apply: dosage and treatment
Vitamin B12 is administered orally, subcutaneously, intramuscularly, intravenously and intra-lumbarly.
Subcutaneously, with Addison-Birmer anemia, 100-200 mcg / day every other day; with funicular myelosis, macrocytic anemia with impaired function of the nervous system – 400-500 µg / day for the first week – daily, then with intervals between injections of up to 5-7 days (at the same time folic acid is prescribed); during remission, a maintenance dose of 100 mcg / day, 2 times a month, in the presence of neurological events, 200-400 mcg 2-4 times a month.
In acute post-hemorrhagic and iron deficiency anemia, vitamin B12 is prescribed in doses of 30-100 mcg 2-3 times a week; with aplastic anemia, 100 µg before the onset of clinical and hematological improvement. For disorders of the nervous system – 200-400 mcg 2-4 times per month.
In diseases of the central nervous system and peripheral nervous system – 200-500 mcg every other day for 2 weeks. For injuries of the peripheral nervous system – 200-400 mcg every other day for 40-45 days.
With hepatitis and cirrhosis of the liver – 30-60 mcg / day or 100 mcg every other day for 25-40 days.
With radiation sickness – 60-100 mcg daily for 20-30 days. With funicular myelosis, amyotrophic lateral sclerosis – endolyumbalno, by 15-30 mcg with a gradual increase in dose to 200-250 mcg for administration.
To eliminate the deficiency of vitamin B12 is administered intramuscularly or intravenously, 1 mg daily for 1-2 weeks; for prophylaxis, 1 mg once a month intramuscularly or intravenously.
For young children with nutritional anemia and premature babies – subcutaneously, 30 micrograms per day for 15 days. With dystrophies in young children, Down’s disease and cerebral palsy – subcutaneously, 15-30 mg per day.
Vitamin B12 has a metabolic, hematopoietic effect. In the body (mainly in the liver) it turns into a coenzyme form – adenosylcobalamin, or cobamamide, which is the active form of vitamin B12 and is part of numerous enzymes, in
Necessary for normal blood – promotes the maturation of red blood cells.
It contributes to the accumulation in the erythrocytes of compounds containing sulfhydryl groups, which increases their tolerance to hemolysis. Activates the blood coagulation system, in high doses causes an increase in thromboplastic activity and prothrombin activity. Reduces the concentration of cholesterol in the blood. It has a beneficial effect on the function of the liver and nervous system. Increases the ability of tissues to regenerate.
CNS: rarely – a state of arousal.
Since the cardiovascular system: rarely – pain in the heart, tachycardia.
Allergic reactions: rarely – urticaria.
When using Vitamin B12 in high doses – hypercoagulation, a violation of the purine metabolism.
Vitamin B12 deficiency must be confirmed diagnostically before prescribing, as it may mask the lack of folic acid.
During the period of treatment, it is necessary to monitor the indicators of peripheral blood: on 5-8 days of treatment, the number of reticulocytes, the concentration of iron. The number of red blood cells, hemoglobin and color indicator must be monitored 1-2 times a week for 1 month, and then 2-4 times a month. Remission is achieved by increasing the number of red blood cells to
Care must be taken when Vitamin B12 is used in people prone to thrombosis with angina pectoris (in smaller doses, to
When used in recommended doses during pregnancy, breastfeeding, as well as in the elderly, there were no adverse reactions other than those listed above.
Vitamin B12 pharmaceutically (in one syringe) is incompatible with ascorbic acid, salts of heavy metals (inactivation of cyanocobalamin), other B vitamins (thiamine bromide, pyridoxine, riboflavin),
Aminoglycosides, salicylates, antiepileptic drugs, colchicine, potassium preparations reduce absorption. Strengthens the development of allergic reactions caused by thiamine.
When used parenterally, chloramphenicol can reduce the hematopoietic effect of cyanocobalamin in anemia.
Can not be combined with drugs that increase blood clotting.
With simultaneous use with hormonal contraceptives for oral administration, it is possible to reduce the concentration of cyanocobalamin in the blood plasma.