Cyanocobalamin (Vitamin B-12) (Into the nose)

Introduction

Cyanocobalamin (sye-an-oh-koe-BAL-a-min)

Treats lack of vitamin B-12, and a condition called pernicious anemia. This medicine is usually given to people who have first been treated with vitamin B-12 injections.

Brand Name(s)

Nascobal

When This Medicine Should Not Be Used

How to Use This Medicine

Gel/Jelly, Spray

• Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
• This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.
• This medicine is for use only in the nose. Do not get any of it in your eyes or on your skin. If it does get on these areas, rinse it off right away.
• Before each use of this medicine, you must prime the pump. To prime the spray or the gel, hold the bottle with the nozzle between two fingers and your thumb on the bottom of the bottle. Pump the bottle until the spray or gel appears, and then pump 2 more times. Now the medicine is ready to use.
• Before using the medicine, gently blow your nose to clear the nostrils.
• After using the medicine, wipe the tip of the bottle with a clean tissue and put the cap back on.
• Carefully follow your doctor's instructions about diet and oral vitamin supplements (pills).
• If you are using this medicine to treat pernicious anemia, you will need to use the medicine for the rest of your life.

How to Store and Dispose of This Medicine

• Keep the bottle tightly closed when not using it. Store at room temperature, away from heat and direct light. Store the medicine bottle upright.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using aminosalicylic acid (Paser®), antibiotics, colchicine, methotrexate (Rheumatrex®), or pyrimethamine (Daraprim®).
• Do not drink hot liquid or eat a hot meal for at least 1 hour before, or 1 hour after using this medicine.
• Do not use folic acid in place of cyanocobalamin to treat your condition.
• Do not drink alcohol while you are using this medicine. Drinking a lot of alcohol can lower your blood levels of vitamin B-12 and may make your condition worse.

Warnings While Using This Medicine

• Make sure your doctor knows if you are pregnant or breast feeding, or if you have liver or kidney disease. Tell your doctor if you have Leber's disease (a genetic disease of the eye).
• This medicine may not be as effective if you use it while you have an infection, a cold, or hay fever symptoms (sneezing, runny nose, or stuffy nose). You may need to wait until your symptoms are better before using this medicine.
• Your doctor will need to check your blood at regular visits while you are using this medicine. Be sure to keep all appointments.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Dry mouth, increased thirst, muscle cramps, nausea or vomiting.
• Fever, chills, cough, sore throat, and body aches.
• Numbness or weakness in your arm or leg, or on one side of your body.
• Pain in your lower leg (calf).
• Shortness of breath, cold sweat, and bluish-colored skin.
• Swelling in your hands, ankles, or feet.
• Swelling of your tongue.
• Unusual bleeding, bruising, or weakness.

If you notice these less serious side effects, talk with your doctor:

• Headache, body pain, joint pain.
• Mild skin itching.
• Nausea, diarrhea.
• Runny or stuffy nose.
• Weakness.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088