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Hydroxocobalamin is first line therapy for people with cyanide poisoning. [2] Hydroxocobalamin converts cyanide to the much less toxic cyanocobalamin. Cyanocobalamin is renally cleared. The use of hydroxocobalamin became first line due to its low adverse risk profile, rapid onset of action, and ease of use in the prehospital setting. [16]
Hydroxocobalamin injection is a clear red liquid solution. Treatment should take into account the cause and severity of the condition. [6] Treatment is done by vitamin B 12 supplementation, either by mouth or by injection. [3] Initially in high daily doses, followed by less frequent lower doses, as the condition improves. [3]
"B12" and "Cbl" redirect here. For other uses of B12, see B12 (disambiguation). For the musical group, see Carbon Based Lifeforms. Pharmaceutical compound Vitamin B12 General skeletal formula of cobalamins Stick model of cyanocobalamin (R = CN) based on the crystal structure Clinical data Other names Vitamin B12, vitamin B-12, cobalamin AHFS / Drugs.com Monograph MedlinePlus a605007 License ...
Cyanocobalamin is commercially prepared by bacterial fermentation. Fermentation by a variety of microorganisms yields a mixture of methylcobalamin, hydroxocobalamin and adenosylcobalamin. These compounds are converted to cyanocobalamin by addition of potassium cyanide in the presence of sodium nitrite and heat.
Hydroxocobalamin injection usp(1000 mcg/ml) is a clear red liquid solution of hydroxocobalamin which is available in a 30-ml brown glass multidose vial packaged in a paper box. Shown is 500 mcg B-12 (as 1/2 cc) drawn up in a 0.5-cc U-100 27 gauge x 1/2" insulin syringe, as prepared for subcutaneous injection.
It is also not known whether current level of evidence sufficient to recommend this relatively expensive strategy as an alternative to cyanocobalamin or hydroxocobalamin. There is currently insufficient evidence on comparative effectiveness and safety of various B12 vitamers (methylcobalamin, cyancobalamin, hydroxocobalamin, adenosylcobalamin).