DRUG SUPPLIED DOSE COMMENTS
CYANOCOBALAMIN (Paeds)
(Vitamin B12)

Mechanism of action:

Vitamin B12, Nutritional supplement


Ref: 44, 289, 290, 291, 292



Last update: 2022-06-17
injection: 100 mcg/mL, 1000 mcg/mL Treatment of B12 Deficiency:
Children:
Initial: 1000 mcg IM/SC daily for 2-7 days then 100 mcg weekly x 1 month (if severe anemia, start with 0.2 mcg/kg/dose IM/SC daily x 2 days then continue with above regimen)
Maintenance: 100 mcg IM/SC once monthly

Adult:
Oral (treatment of choice):
-Pernicious anemia/malabsorption: 1000 mcg PO daily
-For other causes: 250 mcg PO daily
Parenteral (For those with significant neurological symptoms):  
1000 mcg IM/SC daily x 1-5 days, then 1000-2000 mcg PO daily

Supplement for all ages on vegan diet:
5-10 mcg PO daily

Dosage in children is not well-established.

Patients with pernicious anemia require life-long therapy.

Patients with malabsorption require treatment until underlying condition or diet is corrected.

May cause hypokalemia, hypersensitivity, pruritis and vascular thrombosis.

IV route not recommended because of a more rapid elimination.

Contraindicated in Leber's disease (hereditary optic nerve atrophy).


Standard Prescription:

cyanocobalamin__mcg IM/SC daily x __ days
cyanocobalamin__mcg IM/SC__(weekly/monthly)