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Overview: Cyanocobalamin is a form of vitamin B12 that is used to increase vitamin B12 levels. It is available in a variety of forms over the counter as a supplement and by prescription as an injection or nasal spray. Some common side effects may include headache, feeling weak or tired, and nausea. Before using cyanocobalamin, tell your health care provider about all of your health conditions and any medicines or supplements you may be using.

Uses

What is cyanocobalamin used for?

Cyanocobalamin is a form of vitamin B12 commonly used for the following.

These uses may vary depending on the specific cyanocobalamin product prescribed or used.

Cyanocobalamin may also be used for other conditions as determined by your health care provider.

How does cyanocobalamin work (mechanism of action)?

Cyanocobalamin is a form of vitamin B12, which is an essential nutrient. This means you need to eat it or receive it because your body does not make it on its own. Your body uses vitamin B12 to keep nerve and blood cells healthy, make DNA, and prevent pernicious anemia. 

In the United States, most people get enough vitamin B12 from their diet. It is found in animal products, such as meat, milk, and eggs. For most adults, the recommended daily intake of vitamin B12 is 2.4 micrograms (mcg). However, some people either do not get enough from their diet or have trouble absorbing it. When this happens, you can use cyanocobalamin to replace what you are not getting from your diet.

How is cyanocobalamin supplied (dosage forms)?

Brands and other names

  • Berubigen
  • Betalin-12
  • Cobex
  • Crystamine
  • Cyanoject
  • Dodex
  • Nascobal
  • Redisol
  • Rubramin PC
  • Vibisone

Dosage forms and strengths

Cyanocobalamin, also known as vitamin B12, is available as a dietary supplement in various strengths and dosage forms. Cyanocobalamin is also available as a prescription in the following dosage forms and strengths.

  • 500 mcg/spray nasal spray
  • 1,000 mcg/1 mL injection

How should I store cyanocobalamin?

Nasal Spray. Cyanocobalamin nasal spray should be stored upright in the carton (to protect it from light) at room temperature, between 59 F and 86 F (15 C and 30 C). Store in a cool, dry place. Do not freeze it. 

Injection Liquid. Cyanocobalamin injection should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Protect it from light. Store in a cool, dry place.

Dietary Supplement. Cyanocobalamin dietary supplements should be stored according to the product label. If you are not sure how to store it, ask your pharmacist.

Side Effects

What are the most common side effects of cyanocobalamin?

The most common side effects of cyanocobalamin are listed below. These side effects may vary based on the cyanocobalamin product you are using. Tell your health care provider if you have any of these side effects that bother you.

  • Infection in the nose or throat, sore throat, or common cold symptoms
  • Headache
  • Joint pain
  • Feeling unusually weak or tired
  • Dizziness
  • Nausea
  • Tongue swelling
  • Runny nose
  • Tingling feeling in your hands and feet
  • Mild diarrhea

There may be other side effects of cyanocobalamin that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of cyanocobalamin?

While less common, the most serious side effects of cyanocobalamin are described below, along with what to do if they happen.

Severe Allergic Reactions. Cyanocobalamin may cause allergic reactions, which can be serious. Stop using cyanocobalamin and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives, which can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Warnings & Precautions

Who should not use cyanocobalamin?

Allergies to Ingredients. People who are allergic to any of the following should not use cyanocobalamin.

  • Cobalt
  • Cyanocobalamin
  • Vitamin B12
  • Any of the ingredients in the specific product

Your pharmacist can tell you all of the ingredients in the specific cyanocobalamin products they stock.

What should I know about cyanocobalamin before using it?

There are multiple forms of cyanocobalamin available. If cyanocobalamin was prescribed to you by a health care provider, use it as prescribed. If you are using cyanocobalamin as an over-the-counter supplement, follow the instructions that come with the product. If you have any questions about how to use cyanocobalamin, talk to your health care provider.

Do not share cyanocobalamin that was prescribed for you by a health care provider with other people, even if they have the same condition as you. It may harm them.

Keep cyanocobalamin out of the reach of children.

If you are prescribed cyanocobalamin, keep all of your appointments, including for lab tests. Lab tests are used to see how well it is working, see if you need a different dose, and monitor for side effects.

If you are using cyanocobalamin nasal spray and have a runny or stuffy nose, an infection in your nose or throat, or allergies, you should wait until your symptoms get better before using it. It is not known if cyanocobalamin nasal spray works as well when you have these symptoms. Ask your health care provider if you are not sure.

What should I tell my health care provider before using cyanocobalamin?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if cyanocobalamin is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have or have had any of the following.

Leber’s Optic Atrophy. Tell your health care provider if you or anyone in your family has had an eye condition called Leber’s optic atrophy. Cyanocobalamin can make this condition worse.

Planned Surgery. Tell your health care provider if you have an upcoming or planned surgery.

Other Medicines and Supplements. Cyanocobalamin may interact with other medicines and supplements. Before using cyanocobalamin, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Tell your health care provider if you are pregnant or plan to become pregnant. Your health care provider will let you know if you should use cyanocobalamin (and which dosage form you should use) while you are pregnant or trying to get pregnant.

Breastfeeding. Cyanocobalamin passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should use cyanocobalamin (and which dosage form you should use) while breastfeeding.

Interactions

Does cyanocobalamin interact with foods or drinks?

Oral or Injectable Forms. There are no known interactions between oral or injectable cyanocobalamin and foods or drinks.

Nasal Spray. You should not eat hot foods or drink hot liquids within one hour before or after using cyanocobalamin nasal spray. Hot foods and drinks can cause a runny nose. Using cyanocobalamin nasal spray with a runny nose may affect how much of the medicine is absorbed or how well it works. 

It is unknown if drinking alcohol will affect nasal or injectable cyanocobalamin. Drinking large amounts of alcohol may reduce your ability to absorb oral cyanocobalamin and keep it from working.

Does cyanocobalamin interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using cyanocobalamin.

  • A proton pump inhibitor (PPI), such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), or rabeprazole (Aciphex)
  • An H2 blocker, such as cimetidine (Tagamet), famotidine (Pepcid, Zantac), or nizatidine (Axid)
  • Metformin (Fortamet, Glumetza), which is a medicine for diabetes
  • Colchicine, which is a medicine commonly used for gout

This may not be a complete list of medicines that can interact with cyanocobalamin. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much cyanocobalamin?

If you or someone else has used too much cyanocobalamin, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of cyanocobalamin?

If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not use double or extra doses.