Neuroforte-R (Intramuscular)

Cyanocobalamin injection is used to treat or prevent vitamin B12 deficiency caused by the following 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 are doing at regular visits. This will help your doctor see if the medicine is working as it should. Blood tests and other lab tests may be needed to check for side effects.

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

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

Allergies

Inform your doctor if you have ever had any unusual or allergic reactions to this medicine or any other medicines. Also, let your healthcare professional know about any other allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, carefully read the label or package ingredients.

Pediatric

Daily vitamin B12 needs vary by age.

Geriatric

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

Breast Feeding

Studies suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all. In other cases, two different medicines may be used together even if an interaction might happen. If you are taking this medicine, it is very important for your healthcare professional to know if you are taking any of the medicines listed below. The following interactions are significant but may not include all possible interactions.

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

• Chloramphenicol
• Omeprazole

Interactions with Food/Tobacco/Alcohol

Some medicines should not be taken with food or certain types of food, as interactions may occur. Using alcohol or tobacco with some medicines may also lead to interactions. Talk to your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Other medical problems may affect how this medicine is used. 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 may 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 be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or 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 occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may 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.