Cynomin
Generic Name
Cyanocobalamin
Manufacturer
Renata Limited
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| cynomin 250 mcg injection | ৳ 4.51 | N/A |
Description
Overview of the medicine
Cynomin 250 mcg Injection contains Cyanocobalamin, a synthetic form of Vitamin B12, crucial for red blood cell formation, neurological function, and DNA synthesis. It is used to treat and prevent Vitamin B12 deficiency.
Uses & Indications
Dosage
Adults
For pernicious anemia, initially 250 mcg to 1000 mcg daily or every other day for 1-2 weeks, followed by 250 mcg to 1000 mcg monthly for maintenance. Dosage may vary based on the severity of deficiency and individual response.
Elderly
Similar to adult dosage; however, renal function should be considered. Lower initial doses may be appropriate.
Renal_impairment
No specific dose adjustment is generally required, but close monitoring of B12 levels and clinical response is recommended.
How to Take
Cynomin injection should be administered intramuscularly (IM) or deep subcutaneously (SC). It is NOT for intravenous (IV) administration. The injection site should be rotated.
Mechanism of Action
Cyanocobalamin is converted into active coenzymes (methylcobalamin and adenosylcobalamin) which are essential cofactors for various metabolic processes, including DNA synthesis, methionine synthesis (which influences folate metabolism), and conversion of methylmalonyl-CoA to succinyl-CoA. This supports healthy red blood cell production and nervous system maintenance.
Pharmacokinetics
Onset
Hematological response (e.g., reticulocytosis) typically observed within 3-5 days. Neurological improvements may take weeks to months, and some damage might be irreversible.
Excretion
Mainly excreted via the kidneys (urine), with a small amount excreted in bile.
Half life
Circulating half-life is approximately 6 days. Total body stores can last for several years.
Absorption
Rapidly and completely absorbed after intramuscular or deep subcutaneous injection, bypassing the need for intrinsic factor.
Metabolism
Converted to active coenzymes (methylcobalamin and adenosylcobalamin) in the liver and other tissues. Stored primarily in the liver.
Side Effects
Contraindications
- Hypersensitivity to cyanocobalamin, cobalt, or any component of the formulation.
- Leber's disease (a hereditary optic nerve atrophy) due to risk of exacerbation, although evidence is conflicting.
Drug Interactions
Folic acid
Large doses of folic acid may mask Vitamin B12 deficiency symptoms, particularly neurological manifestations.
Chloramphenicol
May decrease the hematologic response to Vitamin B12, especially in patients with megaloblastic anemia. Monitor CBC.
Colchicine, Neomycin, Aminosalicylic acid, Omeprazole, Metformin, H2-receptor blockers
May reduce the absorption of oral Vitamin B12, but this is less relevant for injectable forms.
Storage
Store below 30°C. Protect from light. Do not freeze. Keep out of reach of children.
Overdose
Cyanocobalamin has extremely low toxicity. No specific antidote is known for overdose. Management is supportive and symptomatic.
Pregnancy & Lactation
Cyanocobalamin is generally considered safe and essential during pregnancy and lactation. Adequate Vitamin B12 is vital for fetal development and infant health. Deficiency during pregnancy can lead to adverse fetal outcomes. Consult a doctor.
Side Effects
Contraindications
- Hypersensitivity to cyanocobalamin, cobalt, or any component of the formulation.
- Leber's disease (a hereditary optic nerve atrophy) due to risk of exacerbation, although evidence is conflicting.
Drug Interactions
Folic acid
Large doses of folic acid may mask Vitamin B12 deficiency symptoms, particularly neurological manifestations.
Chloramphenicol
May decrease the hematologic response to Vitamin B12, especially in patients with megaloblastic anemia. Monitor CBC.
Colchicine, Neomycin, Aminosalicylic acid, Omeprazole, Metformin, H2-receptor blockers
May reduce the absorption of oral Vitamin B12, but this is less relevant for injectable forms.
Storage
Store below 30°C. Protect from light. Do not freeze. Keep out of reach of children.
Overdose
Cyanocobalamin has extremely low toxicity. No specific antidote is known for overdose. Management is supportive and symptomatic.
Pregnancy & Lactation
Cyanocobalamin is generally considered safe and essential during pregnancy and lactation. Adequate Vitamin B12 is vital for fetal development and infant health. Deficiency during pregnancy can lead to adverse fetal outcomes. Consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years, when stored under recommended conditions.
Availability
Available in pharmacies and hospitals
Approval Status
Approved by regulatory authorities
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Numerous clinical studies support the efficacy and safety of Cyanocobalamin in treating and preventing Vitamin B12 deficiency and related conditions.
Lab Monitoring
- Serum Vitamin B12 levels
- Complete Blood Count (CBC) with differential
- Reticulocyte count (during initial treatment)
- Serum potassium levels (monitor for hypokalemia during initial therapy for pernicious anemia due to increased erythrocyte production)
Doctor Notes
- Emphasize the importance of adherence to the long-term treatment plan for pernicious anemia.
- Monitor serum potassium levels carefully during the initial phase of treatment for severe megaloblastic anemia.
- Counsel patients on proper injection technique if self-administering, or ensure regular clinical administration.
- Rule out other causes of anemia before initiating B12 therapy.
Patient Guidelines
- Adhere strictly to the prescribed dosing schedule for injections.
- Report any unusual side effects or signs of allergic reaction to your doctor immediately.
- Understand that for conditions like pernicious anemia, lifelong treatment with Vitamin B12 injections may be necessary.
- Do not stop injections without consulting your healthcare provider.
Missed Dose Advice
If a dose is missed, administer it as soon as remembered. If it is almost time for the next scheduled dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Cyanocobalamin injection is not known to affect the ability to drive or operate machinery.
Lifestyle Advice
- Maintain a balanced diet, even if relying on injections for B12, to ensure overall nutritional health.
- Regular follow-up with your healthcare provider is important to monitor your B12 levels and overall health.
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