| DRUG | SUPPLIED | DOSE | COMMENTS |
|---|---|---|---|
| CYANOCOBALAMIN (Paeds) (Vitamin B12) Mechanism of action: Vitamin B12, Nutritional supplement Ref: 44, 289, 290, 291, 292 Last update: 2025-04-27 |
injection: 100 mcg/mL, 1000 mcg/mL tablet: 1000 mcg |
Treatment of B12 Deficiency: Children: Parenteral (preferred): Initial: 1000 mcg IM/SC daily for 2-7 days then 100 mcg IM/SC 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 Oral (alternative): 1000 mcg PO daily Adult: Oral (preferred): -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 mcg IM weekly x 1-4 weeks, then 1000 mcg IM every 1-2 months or 1000-2000 mcg PO daily Supplement for all ages on vegan diet: 5-10 mcg PO daily |
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. Limited evidence for PO route in children – may use in less severe deficiencies/maintenance. Contraindicated in Leber’s disease (hereditary optic nerve atrophy). Folic acid supplementation may also be required. Standard Prescription: cyanocobalamin__mcg IM/SC daily x __ days cyanocobalamin__mcg IM/SC__(weekly/monthly) |