Crystal B-12

Crystal B-12 is part of the drug class:

• Vitamin B12 cyanocobalamin and analogues

Serious side effects have been reported with cyanocobalamin including the following:

• Hypokalemia and sudden death may occur in severe megaloblastic anemia.
• Anaphylactic shock and death. Anaphylactic shock and death have been reported after cyanocobalamin administration.
• "Gasping Syndrome" in premature infants. This product contains Benzyl Alcohol. Benzyl Alcohol has been reported to be associated with a fatal "Gasping Syndrome" in premature infants.
• Aluminum toxicity. This product contains aluminum that may be toxic. Aluminum may reach toxic levels with prolonged administration in patients with impaired kidney function.
• Congestive heart failure. Tell your healthcare provider right away if you experience any of the following symptoms of CHF:
  • sudden weight gain
  • worsening shortness of breath
  • increased swelling of your feet, legs, or abdomen
  • needing to use more pillows to go to sleep or sleeping in a recliner
  • waking from sleep to catch your breath
  • a cough that does not go away
  • new or increasing irregularities in your heart rate
• Production of too many red blood cells.

Do not take cyanocobalamin if you:

• are allergic to cyanocobalamin or to any of its ingredients
• have sensitivity to cobalt

Before taking cyanocobalamin, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to cyanocobalamin or to any of its ingredients
• are allergic to hydroxocobalamin; multi-vitamins; any other medications or vitamins; or cobalt.
• drink or have ever drunk large amounts of alcohol
• have or have ever had Leber's hereditary optic neuropathy (slow, painless loss of vision, first in one eye and then in the other)
• have kidney disease
• are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using cyanocobalamin injection, call your doctor. Talk to your doctor about the amount of vitamin B12 you should get every day when you are pregnant or breast-feeding.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Cyanocobalamin falls into category C.There are no well-controlled studies that have been done in pregnant women. Cyanocobalamin should be used during pregnancy only if the possible benefit outweighs the possible risk to the unborn baby.

However, vitamin B12 is an essential vitamin and requirements are increased during pregnancy. Amounts of vitamin B12 that are recommended by the Food and Nutrition Board, National Academy of Science-National Research Council for pregnant women (4 mcg daily) should be consumed during pregnancy.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication

The recommended dose of cyanocobalamin for the treatment of pernicious anemia is 100 mcg a day. A dose of 100 mcg daily for 6 or 7 days should be administered. If there is clinical improvement the same amount may be given on alternate days for seven doses, then every 3 to 4 days for another 2 to 3 weeks. The regimen will depend on you respond to cyanocobalamin.

This regimen should be followed by 100 mcg monthly for life.

If cyanocobalamin is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.