What is oral cyanocobalamin?

Cyanocobalamin, also known as Vitamin B12, is a form of vitamin B found in foods. Vitamin B12 is important for growth, cell reproduction and energy, healthy red blood cell formation and to keep your nerve cells healthy.

Cyanocobalamin is likely effective in alternative medicine as an aid in treating or preventing low levels of vitamin B12 in your body. Low levels of Vitamin B12 can be caused by an autoimmune disease, pernicious anemia, certain types of surgery, stomach disorders, or malnutrition.

Cyanocobalamin has been used in alternative medicine as a possibly effective aid in treating canker sores, and may help lower homocysteine levels in blood (a risk factor for heart disease).

Cyanocobalamin has also been used to treat memory and thinking problems, Alzheimer’s disease, reduce falls, help with bone health, cataracts, and sleep disorders. However, research has shown that cyanocobalamin may not be effective in treating these conditions.

Cyanocobalamin may also be used for purposes not listed in this medication guide.

Oral cyanocobalamin side effects

Get emergency medical help if you have signs of an allergic reaction: hives, difficult breathing, swelling of your face, lips, tongue, or throat.

Less serious side effects may be more likely, and you may have none at all.

This is not a complete list of side effects and others may occur.

Warnings

Follow all directions on the product label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Before taking this medicine

You should not use cyanocobalamin if you are allergic to vitamin B12, cobalamin, or cobalt.

Ask a doctor, pharmacist, or other healthcare provider if it is safe for you to use this product if you have ever had:

• any condition that makes it hard for your body to absorb nutrients from food (malabsorption);
• cancer; or
• if you use a blood thinner (such as warfarin).

Ask a doctor before using cyanocobalamin if you are pregnant or breastfeeding.

Do not give cyanocobalamin to a child without medical advice.

How should I use oral cyanocobalamin?

When considering the use of cyanocobalamin, seek the advice of your doctor. You may also consider consulting a practitioner who is trained in the use of herbal/health supplements.

If you choose to use cyanocobalamin, use it as directed on the package or as directed by your doctor, pharmacist, or other healthcare provider. Do not use more of this product than is recommended on the label.

Do not use different forms of cyanocobalamin (pills, liquids, and others) at the same time or you could have an overdose.

Carefully follow instructions about whether to take your cyanocobalamin with or without food.

Swallow the extended-release tablet whole and do not crush, chew, or break it.

You must chew the chewable tablet thoroughly before you swallow it.

Measure cyanocobalamin liquid with the supplied measuring device (not a kitchen spoon).

Do not swallow a lozenge, disintegrating tablet, or sublingual tablet whole. Allow it to dissolve in your mouth without chewing. sublingual tablet or liquid should be placed under your tongue.

If you need surgery, tell the surgeon ahead of time that you are using cyanocobalamin. You may need to stop using cyanocobalamin for a short time.

Cyanocobalamin can affect the results of certain lab tests. Tell any doctor who treats you that you are using cyanocobalamin.

The recommended daily dose of cyanocobalamin changes with age. Follow your healthcare provider’s instructions. You may also consult the Office of Dietary Supplements of the NIH, or the USDA Nutrient Database of recommended daily allowances for more information.

Call your doctor if the condition you are treating with cyanocobalamin does not improve, or if it gets worse while using this product.

Store at room temperature away from moisture, heat, and light.

Store the cyanocobalamin liquid in the refrigerator after opening for best results.

Cyanocobalamin dosing information

Usual Adult Dose for Pernicious Anemia:

Initial dose: 100 mcg intramuscularly or deep subcutaneous once a day for 6 to 7 days
If clinical improvement and reticulocyte response is seen from the above dosing:
-100 mcg every other day for 7 doses, then:
-100 mcg every 3 to 4 days for 2 to 3 weeks, then:
Maintenance dose: 100 to 1000 mcg monthly
Duration of therapy: Life

Comments:
-Administer concomitant folic acid if needed.
-Chronic treatment should be done with an oral preparation in patients with normal intestinal absorption.

Usual Adult Dose for B12 Nutritional Deficiency:

25 to 2000 mcg orally daily

Usual Adult Dose for Schilling Test:

1000 mcg intramuscularly is the flushing dose

Usual Pediatric Dose for B12 Nutritional Deficiency:

0.5 to 3 mcg daily

What happens if I miss a dose?

Use cyanocobalamin as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What should I avoid while using oral cyanocobalamin?

Avoid drinking large amounts of alcohol. Heavy drinking can make it harder for your body to absorb cyanocobalamin.

What other drugs will affect oral cyanocobalamin?

Do not use cyanocobalamin without medical advice if you are using any of the following medications:

• vitamin C supplements;
• folic acid;
• potassium supplements;
• oral diabetes medicine that contains metformin; or
• medicines that reduce stomach acid, such as cimetidine, omeprazole, lansoprazole, Nexium, Prevacid, Prilosec, Zantac, and others.

Cholecalciferol is vitamin D3. Vitamin D helps your body absorb calcium.

Cholecalciferol is used as a dietary supplement in people who do not get enough vitamin D in their diets to maintain adequate health.

Cholecalciferol may also be used for purposes not listed in this guide.

Cholecalciferol side effects

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

Stop taking cholecalciferol and call your doctor at once if you have:

• chest pain, feeling short of breath;
• growth problems (in a child taking cholecalciferol); or
• early signs of vitamin D overdose–weakness, metallic taste in your mouth, weight loss, muscle or bone pain, constipation, nausea, and vomiting.

Less serious side effects may be more likely, and you may have none at all.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Warnings

You should not take cholecalciferol if you have had an allergic reaction to vitamin D, or if you have high levels of calcium or vitamin D in your body, or any condition that makes it hard for your body to absorb nutrients from food (malabsorption).

Before taking this medicine

You should not use cholecalciferol if you have had an allergic reaction to vitamin D, or if you have:

• high levels of vitamin D in your body (hypervitaminosis D);
• high levels of calcium in your blood (hypercalcemia); or
• any condition that makes it hard for your body to absorb nutrients from food (malabsorption).

Tell your doctor if you have ever had:

• heart disease;
• kidney disease; or
• an electrolyte imbalance.

Certain forms of cholecalciferol may contain ingredients you should know about, such as peanut or soybean oil, sugar, aspartame (phenylalanine), or certain food dyes. Ask a doctor before using cholecalciferol if you have allergies, diabetes, or phenylketonuria (PKU).

Too much vitamin D could harm an unborn baby or a nursing baby. Ask a doctor before using cholecalciferol if you are pregnant or breastfeeding. Your dose needs may be different during pregnancy or while you are nursing.

Do not give cholecalciferol to a child without medical advice. Your child’s dose will depend on age, weight, diet, and other factors.

How should I take cholecalciferol?

Follow all directions on your prescription label and read all the guides or instruction sheets. Use only the recommended dose of cholecalciferol.

It may be best to take cholecalciferol after a meal, but you may take it with or without food.

Measure liquid cholecalciferol carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

The chewable tablet must be chewed before you swallow it.

To take a disintegrating (Quick-Melt) tablet, place it on your tongue and do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing. If desired, you may drink liquid to help swallow the dissolved tablet.

The cholecalciferol wafer is usually taken only once per week or once per month. Follow your doctor’s dosing instructions very carefully. The wafer must be chewed before you swallow it.

While using cholecalciferol, you will need frequent blood tests. You may also need x-rays.

Your doctor will determine how long to treat you with cholecalciferol.

Cholecalciferol may be only part of a complete program of treatment that also includes dietary changes and taking calcium and vitamin supplements. Follow your doctor’s instructions very closely.

Learn about the foods you should eat to make sure you get enough calcium and vitamin D in your diet. Your cholecalciferol dose may need to be adjusted as you make changes to your diet.

Store at room temperature away from moisture, light, and heat.

Cholecalciferol dosing information

Usual Adult Dose for Vitamin/Mineral Supplementation:

US Recommended Dietary Allowance (RDA) for vitamin D:
18 to 70 years: 15 mcg (600 international units) daily
Tolerable Upper Intake Level: 100 mcg (4000 international units)

Usual Geriatric Dose for Vitamin/Mineral Supplementation:

US Recommended Dietary Allowance (RDA) for vitamin D:
70 years and older: 20 mcg (800 international units) daily
Tolerable Upper Intake Level: 100 mcg (4000 international units)

Usual Pediatric Dose for Vitamin/Mineral Supplementation:

US Recommended Dietary Allowance (RDA) for vitamin D:

0 to 6 months: 10 mcg (400 international units) daily
Tolerable Upper Intake Level (UL): 25 mcg (1000 international units)

7 to 12 months: 10 mcg (400 international units) daily
UL: 38 mcg (1500 international units)

1 to 3 years: 15 mcg (600 international units) daily
UL: 63 mcg (2500 international units)

4 to 8 years: 15 mcg (600 international units) daily
UL: 75 mcg (3000 international units)

9 to 18 years: 15 mcg (600 international units) daily
UL: 100 mcg (4000 international units)

What happens if I miss a dose?

Take cholecalciferol as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line . An overdose of vitamin D can cause serious or life-threatening side effects.

Overdose symptoms may include nausea, loss of appetite, thirst, urinating more or less than usual, body aches, stiffness, confusion, or irregular heartbeats.

What should I avoid while taking cholecalciferol?

Ask a doctor or pharmacist before taking any multivitamins, mineral supplements, or antacids while you are taking cholecalciferol.

What other drugs will affect cholecalciferol?

Certain medications can make it harder for your body to absorb vitamin D. If you take other medications, take them at least 2 hours before or 2 hours after you take cholecalciferol.

Other drugs may affect cholecalciferol, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.