Hydroxocobalamin (injection)

Hydroxocobalamin is a type of vitamin B-12. It is used to treat cyanide poisoning. Hydroxocobalamin helps the body's cells change cyanide into a form that can be removed through urine.

Hydroxocobalamin is used in emergencies to treat cyanide poisoning. This can happen if you are exposed to smoke from a house or industrial fire, if you swallow or breathe in cyanide, or if cyanide gets on your skin.

Hydroxocobalamin may also be used for reasons that are not mentioned in this medication guide.

Hydroxocobalamin is given through an IV into a vein. You will get this injection in a clinic or hospital. Hydroxocobalamin must be given slowly, and the IV infusion can take at least 15 minutes to complete.

Hydroxocobalamin is typically given only once. However, you may receive a second dose if needed.

Your breathing, blood pressure, oxygen levels, heart function, and other vital signs will be monitored closely while you receive hydroxocobalamin.

This medication can cause unusual results in some medical tests. Inform any doctor who treats you that you have recently received a hydroxocobalamin injection.

In an emergency, you might not be able to inform your caregivers about your health conditions. Ensure that any doctor treating you later is aware that you have received Hydroxocobalamin.

If possible, before you receive hydroxocobalamin, inform your caregivers if you have:

• high blood pressure;
• heart disease;
• congestive heart failure;
• liver disease;
• kidney disease (or if you are on dialysis); or
• if you have ever had a severe allergic reaction to hydroxocobalamin, Vitamin B12, or cyanocobalamin (Nascobal, Cobolin, Cyomin, and others).

FDA pregnancy category C. Inform your doctor if you are pregnant. It is not known if hydroxocobalamin will harm an unborn baby. However, the benefits of treating cyanide poisoning may outweigh any risks posed by hydroxocobalamin, for both you and your baby.

It is not known if hydroxocobalamin passes into breast milk or if it could harm a nursing baby. You should not breast-feed after you have been treated with hydroxocobalamin.

In an emergency, it may not be possible to inform your caregivers if you are pregnant or breastfeeding before you are treated with hydroxocobalamin. Ensure that any doctor caring for your pregnancy or your baby is aware that you have received this medication.

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

You may develop an acne-like skin rash within 1 to 4 weeks after you are treated with hydroxocobalamin. This rash should go away without treatment. Call your doctor if you have a rash that lasts longer than 4 weeks.

Call your doctor at once if you have a serious side effect such as:

• bright red blood in your stools;
• chest pain, fast or uneven heart rate;
• severe shortness of breath, wheezing, gasping for breath, cough with foamy mucus;
• swelling in your feet or ankles;
• a light-headed feeling, like you might pass out; or
• dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Common side effects of Hydroxocobalamin may include:

• nausea;
• headache;
• acne, skin rash or redness;
• red coloring of your urine (may last 2 to 5 weeks); or
• pain, swelling, or irritation of your skin where the injection was given.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Since hydroxocobalamin is given by a healthcare professional in an emergency situation, it is unlikely that you will miss a dose.

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to happen.

If your skin turns red after you receive this medication, stay away from sunlight or tanning beds. Hydroxocobalamin can make you sunburn more easily while your skin is still red. Wear protective clothing and use sunscreen (SPF 30 or higher) until your skin color goes back to normal.

Other drugs may interact with hydroxocobalamin, including prescription and over-the-counter medicines, vitamins, and herbal products. Inform all of your health care providers about all medicines you are currently using and any medicines you begin or stop using.