Cobal (Intramuscular)

Cyanocobalamin injection is used to treat or prevent vitamin B12 deficiency caused by these conditions:

• Addisonian (pernicious) anemia
• Stomach or bowel problems
• Worm infestation
• Pancreas or bowel cancer
• Folic acid deficiency.

This medicine should only be given by your doctor or under their direct supervision.

It is very important for your doctor to check how you or your child is doing at regular visits. This will help your doctor see if the medicine is working correctly. Blood tests and other lab tests may be needed to check for side effects.

Do not take other medicines unless your doctor has talked about them with you. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

In deciding to use a medicine, you and your doctor will consider the risks and benefits. For this medicine, keep the following in mind:

Allergies

Inform your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also, tell your healthcare professional about any other allergies you may have, including those to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Daily vitamin B12 needs vary by age.

Geriatric

There is no information available on how age affects the use of cyanocobalamin injection in older patients.

Breast Feeding

Research in women indicates that this medication poses minimal risk to the baby when used during breastfeeding.

Interactions with Medicines

Some medicines should not be used together, while others can be used together even if there may be interactions. In such cases, your doctor may adjust the dose or take other precautions. It is very important for your healthcare professional to know if you are taking any of the following medicines while receiving this medicine. The following interactions are significant and may not include all possible interactions.

Using this medicine with any of the following medicines may increase the risk of certain side effects, but taking both may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or frequency for one or both.

• Chloramphenicol
• Omeprazole

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be taken around mealtime or with specific foods due to potential interactions. Using alcohol or tobacco with certain medicines may also lead to interactions. Talk to your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical problems may influence the use of this medicine. Be sure to inform your doctor if you have any other medical issues, especially:

• Allergy to cobalt—Should not be used in patients with this condition.

• Kidney disease—Use with caution. May increase the risk of more serious side effects.

• Megaloblastic anemia, severe—May increase the risk of hypokalemia.

Along with its needed effects, a medicine may cause some unwanted effects. Not all of these side effects will happen, but if they do, you may need medical attention.

Check with your doctor or nurse right away if any of the following side effects occur:

Incidence not known

• Abdominal or stomach pain
• bleeding from the gums or nose
• blue lips and fingernails
• chest pain
• cough
• coughing that sometimes produces a pink frothy sputum
• decreased urine output
• difficult, fast, noisy breathing, sometimes with wheezing
• difficulty with swallowing
• dilated neck veins
• dizziness
• extreme fatigue
• eye pain
• fast heartbeat
• headache
• hives, itching, or skin rash
• increased sweating
• irregular breathing
• irregular heartbeat
• pale skin
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• ringing in the ears
• swelling of the face, fingers, feet, or lower legs
• tightness in the chest
• unusual tiredness or weakness
• weight gain

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Your health care professional may also have ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue, are bothersome, or if you have any questions about them:

Incidence not known

• Diarrhea
• skin rash with a general disease

Other side effects not listed may also happen in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You can report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Cobal
• LA-12
• Neuroforte-R
• Vita #12
• Vitabee 12

In Canada

• Bedoz

Available Dosage Forms:

• Solution

Therapeutic Class: Nutritive Agent

Pharmacologic Class: Vitamin B (class)

A nurse or other trained health professional will give you this medicine. This medicine is given as a shot into a muscle.

If you are using this medicine to treat vitamin B12 deficiency caused by pernicious anemia, you will need to use the medicine for the rest of your life.

Tell your doctor if you are on a vegetarian diet.