Cyanocobalamin, Vitamin B₁₂ nasal gel

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What is cyanocobalamin nasal gel?

CYANOCOBALAMIN (Nascobal® nasal gel) is a synthetic (man-made) form of vitamin B₁₂. Naturally occurring vitamin B₁₂ is found in fish, seafood, milk, egg yolk and fermented cheeses. Vitamin B₁₂ is essential to the development of healthy blood cells, nerve cells, and proteins in the body and for the normal metabolism of fats and carbohydrates in the body. Lack of vitamin B₁₂ can result in anemia, stomach problems, and nerve damage. Cyanocobalamin treats or prevents vitamin B₁₂ deficiency and a resulting type of anemia, called pernicious anemia. Pernicious anemia occurs in patients who do not have enough vitamin B₁₂ in their diet (e.g., strict vegetarians) or who cannot adequately absorb the vitamin due to a defect or disease of the stomach or intestines. Generic cyanocobalamin nasal gel is not available.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
• hereditary optic nerve atrophy (Leber's disease)
• an unusual or allergic reaction to cyanocobalamin, cobalt, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant

How should I take this medicine?

Cyanocobalamin nasal gel is only for use in the nose. Prior to the first use of a new nasal pump, you must prime it so it will administer the vitamin properly. Follow the package directions. Prime the pump by spraying it into the air 7—8 times before use until the medicine spray is visible.

Follow the directions on the prescription label. Blow nose gently, without squeezing. With head upright, spray the medicine into one nostril. Sniff briskly while squeezing the bottle quickly and firmly. After use, rinse the tip of the spray bottle with hot water, taking care not to suck water into the bottle. Dry with a clean tissue. Replace the cap directly after cleaning. Do not use the bottle for more than one person. Do not use extra doses or use more of this medicine than your prescriber or health care professional has prescribed.

What if I miss a dose?

If you miss a dose, skip the missed dose, there is no cause for concern. Do not take double or extra doses.

What drug(s) may interact with cyanocobalamin?

• alcohol
• chloramphenicol
• colchicine
• hot foods or liquids
• phenobarbital
• phenytoin
• primidone

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking cyanocobalamin?

Unless you have pernicious anemia or a condition where you cannot absorb cyanocobalamin, make sure you have a proper diet. Having vitamin supplements is not a substitute for a healthy diet. Foods that contain vitamin B₁₂ include fish, seafood, egg yolk, milk and fermented cheeses. There is no Vitamin B₁₂ in any vegetables; therefore, strict vegetarians are at an increased risk of vitamin B₁₂ deficiency.

There is no scientific evidence to support claims that cyanocobalamin can treat various other problems (such as allergies, mental problems, nerve disorders, skin problems). Treating yourself with large doses of cyanocobalamin can be unsafe. Do not treat yourself without your prescriber's advice.

Certain factors can increase your chance of getting vitamin B₁₂ deficiency. These include some infections or other illness, periods of stress, genetic disorders, patients who smoke or those with a high alcohol intake. Restrict your alcohol intake and avoid smoking to get the best benefit.

What side effects may I notice from taking cyanocobalamin?

Serious side effects from cyanocobalamin are rare, but severe allergic reactions (progressing to fluid in the lungs or congestive heart failure) can occur. Side effects with cyanocobalamin include:
• chest tightness or pain
• difficulty breathing, wheezing or shortness of breath
• skin rash, redness and itching

Minor side effect with cyanocobalamin:
• headache
Let your prescriber or health care professional know about this side effect if it does not go away.

Where can I keep my medicine?

Keep out of the reach of children.

Store the container upright at room temperature between 15 and 30 degrees C (59 and 85 degrees F). Store away from heat and light. Throw away any unused medicine after the expiration date.

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.