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Drugs reference index «Cyanocobalamin»


Brand names: Nascobal

Why is Cyanocobalamin prescribed?

Nascobal nasal spray is for the maintenance of normal red blood cell (RBC) levels in anemia patients who are in remission following vitamin B12 therapy.

Most important fact about Cyanocobalamin

Low potassium levels as well as sudden death have been reported in severely anemic patients who were intensely treated with vitamin B12. Folic acid supplements are not a substitute for vitamin B12. Using only folic acid, instead of B12, may result in severe and irreversible neurological damage.

Once beginning nasal therapy for anemia with Nascobal, you are required to take your weekly dose of Cyanocobalamin for the rest of your life. Failure to keep up with your therapy will result in severe damage to your nerves and spinal cord.

How should you take Cyanocobalamin?

Nascobal Nasal Spray should be administered at least one hour before or one hour after ingestion of hot foods or liquids.

Before the first dose and administration, the pump must be primed. Remove the clear plastic cover and the plastic safety clip from the pump. To prime the pump, place nozzle between the first and second finger with the thumb on the bottom of the bottle. Pump the unit firmly and quickly until the first appearance of spray. Then prime the pump an additional 2 times. Now the nasal spray is ready for use. The unit must be re-primed before each dose. Prime the pump once immediately before each administration of doses 2 through 8.

  • Storage instructions...Store at room temperature, standing up.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Cyanocobalamin.

  • Side effects may include:Arthritis, anxiety, back pain, dizziness, general aching, headache, infection, nasal infection, nausea, sore throat, upset stomach, vomiting

Why should Cyanocobalamin not be prescribed?

Do not take Nascobal if you are allergic to vitamin B12.

Special warnings about Cyanocobalamin

Hot foods may cause nasal secretions and a resulting loss of medication; therefore, patients should be told to administer Nascobal at least one hour before or one hour after ingestion of hot foods or liquids.

Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Nascobal. Also, talk to your doctor about your complete medical history, especially about your daily diet; if you follow a vegetarian diet, you may be instructed to take Nascobal once per week.

Possible food and drug interactions when taking Cyanocobalamin

If Nascobal is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Nascobal with the following:

AlcoholAntibioticsColchicineMethotrexatePara-aminosalicylic acidPyrimethamine

Special information if you are pregnant or breastfeeding

If you are pregnant, planning to become pregnant, or are breastfeeding, talk to your doctor about taking Nascobal. Increased levels of vitamin B12 are needed while pregnant and nursing.

Recommended dosage for Cyanocobalamin


The usually dosage of Nascobal Nasal Spray is one spray (500 micrograms) in one nostril once a week.


Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

  • Cyanocobalamin Prescribing Information (FDA)
  • Calomist Prescribing Information (FDA)
  • Calomist Consumer Overview
  • Nascobal Spray MedFacts Consumer Leaflet (Wolters Kluwer)
  • Nascobal Prescribing Information (FDA)
  • vitamin b12 Nasal, Oral, Parenteral Advanced Consumer (Micromedex) - Includes Dosage Information

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