Cyanocobalamine vitaminv12

General characteristics. Structure:

1 ml of solution contains cyanocobalamine 0,5 mg (500 mkg); and excipients: sodium chloride, water for injections.

Pharmacological properties:

Pharmacodynamics. Cyanocobalamine activates exchange of carbohydrates, proteins and lipids, takes part in synthesis of labile methyl groups, in formation of sincaline, methionine, nucleic acids, creatine, promotes accumulation in erythrocytes of connections with sulphhydryl groups. Being a growth factor, stimulates function of marrow that is necessary for a normoblastic erythrogenesis. Drug contributes to normalization of the broken functions of a liver and a nervous system, activates system of a blood coagulation, causes (high doses) increases in thromboplastic activity and activity of a prothrombin. In a human body and animals it is synthesized by intestinal microflora, but the need for vitamin is not provided with this synthesis and its organism receives additional quantity with food stuffs.

Pharmacokinetics. It is metabolized in fabrics, turning into a coenzymatical form - аденозилкобаламин, being an active form of cyanocobalamine. It is removed by bile and with urine.

Indications to use:

Malignant, posthemorrhagic and iron deficiency anemias; aplastic anemias at children, anemias of alimentary character; the anemias caused by toxic substances and medicines, the anemias connected with deficit of B12 vitamin irrespective of the deficit reasons (a stomach resection, helminthic invasions, disturbance of process of absorption of intestines, pregnancy). Polyneurites, epileptiform neuralgias, radiculitis, kauzalgiya, diabetic neuritis, amyotrophic side sclerosis. To Spr (together with folic acid), liver diseases (hepatitises, cirrhoses), a radial illness.

Route of administration and doses:

Cyanocobalamine is entered intramusculary, subcutaneously or intravenously, and at a side amyotrophic sclerosis also intralyumbalno.
Treatment of adults. At the anemias caused by toxic substances and medicines
the anemias proceeding with deficit of B12 vitamin irrespective of the deficit reasons (a stomach resection, helminthic invasions, disturbance of process of absorption of intestines, pregnancy) appoint in doses 100 - 200 mkg (0,1 – 0,2 mg) every other day before achievement of remission. At a malignant anemia with symptoms of a funicular myelosis and at macrocytic anemias with defeat of a nervous system cyanocobalamine is applied the adult in a single (daily) dose of 400-500 mkg (0,4-0,5 mg). In the first week enter daily, and then an interval between introductions in 5-7 days (at the same time appoint folic acid). In hard cases enter into the spinal canal, since a single dose of adult 15-30 mkg (for such doses Cyanocobalamine of other concentration is appointed), and at each subsequent injection
increasing a dose (50, 100, 150, 200 mkg). Intralyumbalny injections do each 3 days, all on a course 8-10 injections are necessary. During remission in the absence of the phenomena of a funicular myelosis, for maintenance of therapy appoint 100 mkg twice a month, in the presence of neurologic symptoms -
the adult on 200-400 mkg (0,2-0,4 mg) 2-4 times within a month. At a side amyotrophic sclerosis, a polyneuritis, an epileptiform neuralgia, radiculitis, a kauzalgiya the drug is administered in the increasing doses adult from 200 to 500 mkg (from 0,2 to 0,5 mg) on an injection in days, at improvement of a state - 100
mkg a day. A course of treatment - up to 2 weeks. At liver diseases (hepatitises, cirrhosis) appoint the adult 100 mkg every other day within 25-40 days. At an acute radial illness, a diabetic neuropathy, the spra the adult is appointed on 60 - 100 mkg daily for 20-30 days. Treatment duration cyanocobalamine and carrying out repeated courses depend on the nature of a disease and efficiency of treatment.
Treatment of children. At posthemorrhagic and iron deficiency anemias to children aged from 3 years appoint 30-100 mkg 2-3 times a week. At aplastic anemias to children aged from 3 years enter 100 mkg daily before approach kliniko-hematologic improvement. The average therapeutic dose for children makes 1 mkg/kg daily, the average duration of use of drug – 10 days.

Features of use:

In cases of manifestation of side reactions use of cyanocobalamine temporary or at all is cancelled. In need of treatment by cyanocobalamine use of drug is resumed, since small doses of drug (50 mkg). At treatment cyanocobalamine carries out systematic control of blood test. In case of a tendency of development leucio-and a hyperglobulia the dose of drug needs to be reduced or to temporarily interrupt treatment. It is also necessary to control coagulability of blood, being careful at tendency to a thrombogenesis. With care appoint also sick with stenocardia, and in smaller doses (no more than 100 mkg of cyanocobalamine a day). Use of drug during pregnancy and feeding by a breast perhaps in cases when the expected advantage for mother exceeds risk for a fruit and
child. The control of vehicles and performance of other work requiring special attention is forbidden.

Side effects:

At hypersensitivity to cyanocobalamine the allergic phenomena, a headache, dizziness, nervous excitement, pains in heart, tachycardia can be observed.

Interaction with other medicines:

Joint administration of drug in one syringe with B1 and B6 vitamins as the ion of cobalt promotes destruction of other vitamins is not recommended. It is also necessary to consider that B12 vitamin can strengthen the allergic reactions caused by B1 vitamin.

Contraindications:

Use of cyanocobalamine is contraindicated at an erythremia, a hyperglobulia, acute thromboembolic diseases, new growths except for the cases which are followed by megaloblastichesky anemia and deficit of B12 vitamin. Children's age up to 3 years for a dosage form in this dose.

Overdose:

At overdose the fluid lungs, congestive heart failure, thrombosis of peripheral vessels, a small tortoiseshell are possible, is more rare - an acute anaphylaxis.
Symptomatic treatment.

Storage conditions:

Store in the unavailable to children, protected from light place at a temperature of 15-25 °C. A period of storage - 2 years.

Issue conditions:

According to the recipe

Packaging:

On 1 ml in ampoules; on 10 ampoules in a box or a pack.