Cyanocobalamin (oral)

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients

Cautions

• Pregnancy
• Renal impairment
• Indiscriminate use
• Pernicious anaemia (ensure adequate dosing and observe blood picture)

Pregnancy

• Caution
• Cyanocobalamin should not be used for the treatment of megaloblastic anaemia of pregnancy unless vitamin B12 deficiency has been demonstrated
• Cyanocobalamin should not be used during pregnancy unless the benefit outweighs the risk

Breastfeeding

• Compatible
• Cyanocobalamin is secreted into breast milk but this is unlikely to harm the infant and may be beneficial if the mother and infant are vitamin B12 deficient

Renal Impairment

• Caution; no dose adjustment recommended

Hepatic Impairment

• No dose adjustment recommended

Elderly

• No dose adjustment recommended 

Porphyria Information

• Not porphyrinogenic (NP)

Skin and Subcutaneous Tissue Disorders

• Itching exanthema
• Acneform
• Bullous eruptions

Immune, Blood and Lymphatic System Disorders

•  Anaphylactic shock

• Para-aminosalicylic acid
• Colchinine
• Biguanides
• Neomycin
• Cholestyramine
• Potassium chloride
• Methyldopa
• Cimetidine
• Chloramphenicol
• Oral contraceptives
• Anti-metabolities
• Antibiotics

Vitamin B12 is used in the body in two forms, namely methylcobalamin and 5-deoxyadenosyl cobalamin. Both these substances are cofactors needed in enzymatic processes. Methylcobalamin is essential for eventual DNA methylation, while 5-deoxyadenosyl cobalamin is needed in the extraction of energy from proteins and fats and for the production of haemoglobin.