Cyanocobalamin is indicated for:

- Treatment of nutritional vitamin B12 deficiency

- Treatment of vitamin B12 deficiency following partial gastrectomy

- Treatment of tropical sprue, alone or with folic acid

- Treatment of pernicious anaemia when parenteral administration is not possible or not advised.

Posology

Adults: one to three tablets (50 to 150 micrograms) or more daily at the discretion of the physician.

In pernicious anaemia intramuscular therapy is preferable for initial correction of vitamin B12 deficiency. However, if necessary, the oral route may be used to follow this, in which case at least 300 micrograms should be given daily.

Elderly: The normal dose for adults is appropriate for the elderly.

Paediatric population: One tablet (50 micrograms) daily at the discretion of the physician.

Method of administration: Oral.

This medicine should be taken between meals.

Hypersensitivity to the active substance or to any of the excipients listed in section 6.1.

For pernicious anaemia, an adequate dose must be used and the blood picture must be examined regularly at least every three months for 18 months until stabilised, and then annually.

Indiscriminate administration of this medicine may mask precise diagnosis.

Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take this medicine.

Absorption may be reduced by Para-aminosalicylic acid, colchinine, biguanides, neomycin, cholestyramine, potassium chloride, methyldopa, and cimetidine.

Patients treated with chloramphenicol may respond poorly to this medicine.

Serum levels of this medicine may be lowered by oral contraceptives. These interactions are unlikely to have clinical significance.

Anti-metabolities and most antibiotics invalidate vitamins B12 assays by microbiological techniques.

Pregnancy

This medicine should not be used to treat megaloblastic anaemia of pregnancy because this is due to folate deficiency.

None

Sensitisation to this medicine is rare, but may present as an itching exanthema, and exceptionally as anaphylactic shock.

Acneform and bullous eruptions have been reported rarely.

Patients who have become sensitised to this medicine by injection are often able to tolerate the oral route without trouble.

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

Overdosage is unlikely to require treatment.

Pharmacotherapeutic group: Antianemic preparations, Vitamin B12 (cyanocobalamin).

ATC code: B03BA01

This medicine contain cyanocobalamin vitamin B 12, which is used for the treatment of pernicious anaemia, and nutritional deficiencies of vitamin B 12 which results in macrocytic anaemia.

Absorption:

The absorption of cobalamins from the gut is dependent upon the glycoprotein intrinsic factor.

Distribution:

Cobalamins are transported rapidly into the blood bound to protein, known as transcobalamins.

Elimination:

Cobalamins are stored in the liver and excreted in the bile. They are known to cross the placenta.

No further relevant data

Lactose monohydrate

Microcrystalline cellulose (pH101)

Croscarmellose sodium

Magnesium stearate

Readymade coating material pink:

Hypromellose HPMC 2910 (E464)

Titanium dioxide (E171)

Macrogol/polyethylene glycol

Carmine (E120)

Black iron oxide (E172)

Not Applicable

Unopened bottle packs with silica gel: 24 months

Unopened bottle packs: 18 months

Opened bottles: After first opening use within 100 days

Bottle packs: Store below 25° C. Store in the original package in order to protect from moisture. Keep the bottle container tightly closed.

HDPE containers with a polypropylene cap containing 50 tablets. Each container contains a silica gel desiccant pouch, which must be kept in the container to help protect your tablets, and it should not be swallowed

HDPE containers with a polypropylene cap containing 50 and 100 tablets

Not all pack sizes may be marketed

No special requirements.