What it's for (Indications)
- Used for the management of neuralgia (nerve disorder pain), pain caused by neuritis (inflammation of nerves), and for the treatment of megaloblastic anemia.
Dosage Information
| Type | Guideline |
|---|---|
| Standard | Prior to treatment, obtain hematocrit, reticulocyte count, vitamin B12, folate, and iron levels. The recommended initial dose is one spray (500 mcg) in one nostril once weekly. Administer at least one hour before or one hour after ingestion of hot foods or liquids. Monitor serum B12 levels periodically; obtain a serum B12 level and peripheral blood count one month after treatment initiation, then subsequently at intervals of 3 to 6 months. If serum levels of B12 decline after one month of treatment, consider increasing the dose. Assess serum B12 level one month after each dose adjustment. If serum B12 levels are persistently low, consider alternative therapy (e.g., intramuscular or subcutaneous vitamin B12 therapy). Other concomitant therapies should also be considered. |
Safety & Warnings
Common Side Effects
- Common side effects include cyanosis (skin turns blue), skin eruptions, hypoglycemia (low blood sugar), CNS stimulations, redness at injection site, hypotension (low blood pressure), tachycardia (increased heart rate), infection, headache, glossitis, paresthesia, asthenia, nausea, and rhinitis.
Serious Warnings
- Black Box Warning: None
- Severe warnings include the risk of severe optic atrophy in patients with Leber’s Disease, potential for anaphylactic reactions, and risk of hypokalemia and thrombocytosis with intense treatment of megaloblastic anemia.
- Patients with hepatic (liver) problems should use this medicine with caution.
- Consult a doctor regarding use during pregnancy and lactation.
How it Works (Mechanism of Action)
Vitamin B12 can be converted to coenzyme B12 in tissues, and as such is essential for conversion of methylmalonate to succinate and synthesis of methionine from homocysteine, a reaction which also requires folate. In the absence of coenzyme B12, tetrahydrofolate cannot be regenerated from its inactive storage form, 5-methyltetrahydrofolate, and a functional folate deficiency occurs. Vitamin B12 also may be involved in maintaining sulfhydryl (SH) groups in the reduced form required by many SH-activated enzyme systems. Through these reactions, vitamin B12 is associated with fat and carbohydrate metabolism and protein synthesis.
Commercial Brands (Alternatives)
No other brands found for this formula.