Cyanocobalamin (B12 or Cobalamin)

By Kayla Hyland, DVM; Rania Gollakner, BS, DVM, MPH

What is cyanocobalamin?

Cyanocobalamin (vitamin B12 or cobalamin) is a vitamin supplement used to treat systemic deficiencies of vitamin B12 due to metabolic or genetic disorders.

Its use in cats and dogs to treat vitamin deficiencies is sometimes “off label” or “extra label”. Many drugs are commonly prescribed for off-label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions carefully, as their directions may be significantly different from those on the label.

How quickly does cyanocobalamin work?

Cyanocobalamin can take several weeks of treatment before improvement is seen.

How is cyanocobalamin given?

Cyanocobalamin is given by mouth in the form of an oral tablet or is given under the skin in the form of an injectable solution. In some cases, a member of your veterinary healthcare team may show you how to properly inject this medication.

What if I miss giving my pet the medication or my shipment is late?

Give the dose as soon as you remember and start a new weekly or monthly dosing schedule. For example, if you forgot to give your pet their monthly dose on June 1 and remember on June 18, give the dose on June 18 and start a new monthly schedule. The next dose your pet will receive would be on July 18. Do not give your pet two doses at once.

Contact your veterinarian if you are concerned about a missed dose.

Are there any potential side effects?

This medication is a longer-acting supplement that appears to be very well tolerated in animals. The injection may sting but typically resolves quickly. The effects of this medication may last for a few days.

Are there any risk factors for this medication?

No risk factors are documented for injectable or oral use in pets. It is likely safe to use in pregnant animals and is safe to use in nursing mothers and young animals.

Are there any drug interactions I should be aware of?

Chloramphenicol should be used with caution when given with cyanocobalamin because it may decrease response to the drug. Long-term use of omeprazole or pantoprazole may reduce cyanocobalamin absorption in humans; veterinary significance is unknown.

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

Is there any monitoring that needs to be done with this medication?

Your veterinarian may monitor your pet to be sure that the medication is working. Your veterinarian may recommend a baseline blood panel before starting treatment with cyanocobalamin and will recheck once treatment has begun.

Serum cobalamin levels should be checked 1 month after the first injectable dose. If the concentration is low, your veterinarian may increase the dosing from once weekly to twice weekly. Levels should also be checked 12 weeks after starting oral cobalamin tablets.

How do I store cyanocobalamin?

Tablets should be stored in tight containers at room temperature and protected from light. Cyanocobalamin injectable should be stored below 40°C (104°F) and protected from light and freezing.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.

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