Vitamin B12 (Hydroxocobalamin)
Trade name
Hydroxocobalamin Chloride:
Hydroxo-B12, Neo-B12
Hydroxocobalamin Acetate:
Cobal-B12, Vita-B12
Cyanokit, Hydroxocobalamin Acetate (Sterop)
Note: Cyanokit and Hydroxocobalamin Acetate (Sterop) are not licenced in Australia at the time of publication. The information in this monograph applies to the specified brand, formulation and strength only.
Presentation and preparation
For IV administration:
|
Vial size
(powder volume) |
Fluid to add
|
Volume to add
|
Resulting concentration
|
|---|---|---|---|
|
Cyanokit only: 5 g (negligible) |
Sodium chloride 0.9% OR other compatible fluid | 200 mL | 25 mg/mL |
Cyanokit only: Reconstitute using the transfer spike with 200 mL of sodium chloride 0.9% or other compatible fluid to provide a 25 mg/mL solution. Invert the vial repeatedly for at least 1 minute to mix. Do not shake.
For IM administration:
Hydroxo-B12, Neo-B12, Cobal-B12, Vita-B12:
1 mg/mL (volume: 1 mL)
Hydroxocobalamine Acetate (Sterop):
5 mg/mL (volume: 2 mL)
IV administration
All brands except Cyanokit:
Never administer intravenously.
Cyanokit only:
Give reconstituted solution over 15 minutes. If a second dose is required, give over 15 minutes to 2 hours.
Other routes of administration
All brands except Cyanokit:
IM: Suitable. Give undiluted.
SC: Not recommended. May be given as an intermittent injection or infusion under specialist care settings only when alternate routes are no longer feasible.
Cyanokit only:
IM: Not recommended.
SC: Not recommended.
Compatible IV Fluids
Cyanokit only:
Glucose 5%
Hartmann’s
Sodium chloride 0.9%
Additional information
Usage may interfere with some clinical laboratory evaluations.
Protect from light during storage.
All brands except Cyanokit:
Extravasation risk.
Solution should be clear, and pale to deep red.
Consider an intradermal test dose before administration in patients who may be sensitive to cobalamins.
Cyanokit only:
Administration may cause significant hypertension. Monitor blood pressure during and after infusion.
Reconstituted solution should be clear and deep red.
The colour of the infusion may cause haemodialysis machines to shut down or interfere with alarms due to erroneous ‘blood leak’ detection.
Reconstituted vial is stable for 6 hours. Discard any unused vial contents.
Contact the Poisons Information Centre for more detailed information: 13 11 26.