HomeNDC LookupIngredientsCyanocobalamin › 00143-9619-01
Cyanocobalamin 1000 ug/mL Injection, 30 mL — NDC 00143-9619-01 package photo

Cyanocobalamin 1000 ug/mL Injection, 30 mL

by Hikma Pharmaceuticals USA Inc. · 30 mL in 1 VIAL, MULTI-DOSE (0143-9619-01)
NDC 00143-9619-01
🏷️ FDA NDC (as labeled) 0143-9619-01 billing pads the labeler segment with a zero
This package
Contains30 mL Cost per mL$0.7938 NADAC Per package$23.81 / 30 ml Pack sizes2 compare ↓
Also priced by: Medicaid pays $2.86/unit — full pricing hub ↓
Also comes in: 10 vials 00143-9619-10
Rx only Generic On market Non-controlled
🗂️ Data synced Jul 24, 2026 · sources: openFDA · FDA label (DailyMed) · FDA Orange & Purple Book · First Databank · CMS NADAC, ASP, Medicare & Medicaid · RxNorm
📋 All sources & update times →
⚠️
Other active recalls for Cyanocobalamin (different manufacturers) — 2 · tap to view
These affect other manufacturers’ products for the same ingredient — not necessarily the exact NDC on this page.
Class II · Jul 24, 2026 — Presence of Particulate Matter: Product contaminated with particulate matter identified as hair, glass and/or paraformaldehyde (American Regent, Inc.) · FDA recall D-0793-2026
Class II · Jul 24, 2026 — Presence of Particulate Matter: Product contaminated with particulate matter identified as hair, glass and/or paraformaldehyde (American Regent, Inc.) · FDA recall D-0792-2026
Each entry is an official FDA enforcement report — look up any recall number in the FDA recall database ↗

🆔 Identity & classification

FDA NDC (as labeled) 0143-9619-01
Product NDC 0143-9619
11-digit billing NDC 00143961901
NCPDP billing unit ML — per mL (volume)
RxCUI 309594
UNII P6YC3EG204
UPC 0301439620105
Application # ANDA080515
SPL Set ID a66eb3c4-3e1d-4d49-b963-4fa2334cc9b6
Established class (EPC) Vitamin B12
Chemical class Vitamin B 12
DEA schedule Non-controlled
Marketing category ANDA
Marketing status On market
FDA listing status Listed (active directory)
Marketing start 1971-10-20
Route INTRAMUSCULAR, SUBCUTANEOUS
Dosage form INJECTION
Substance CYANOCOBALAMIN
GPI-14 82100010002015
GPI class Cyanocobalamin
GCN Seq No 002329
GCN 94594
HICL code 001053
Ingredient (HICL) Cyanocobalamin (Vitamin B-12)
HIC1 code C
Therapeutic class — broad (HIC1) Electrolyte Balance/Metabolism/Nutrition
HIC2 code C6
Therapeutic class — intermediate (HIC2) Vitamins
HIC3 code C6L
Therapeutic class — specific (HIC3) Vitamin B12 Preparations
AHFS code 88:08.00.00
AHFS class Vitamin B Complex
FDB label name CYANOCOBALAMIN 30,000 MCG/30ML
FDB brand name Cyanocobalamin Injection
Legend status F — Federal legend — prescription drug or device
TE code (Orange Book) AP · RLD · RS
Why two NDCs? The FDA registers this code as 0143-9619-01 — a 4-4-2 layout, and that's what's printed on the package and shown on DailyMed. For insurance claims, every NDC is standardized to a uniform 11-digit 5-4-2 format by adding a zero to the labeler segment → 00143-9619-01. Same drug, same package — only the format differs.
Where does this data come from?
Identifiers from the FDA openFDA NDC Directory and Structured Product Labeling; RxCUI from RxNorm (NLM); GPI from Medi-Span; GCN / HIC / AHFS / legend from First Databank.

🏷️ RxNorm drug class

This medicine belongs to the Vitamin B12 class.

Pharmacologic class Vitamin B12
Drug family (ATC) Vitamin B12 (cyanocobalamin and analogues)
Where does this data come from?
Therapeutic classes from RxNorm RxClass (U.S. National Library of Medicine) — Established Pharmacologic Class (FDA), ATC drug family (WHO) and mechanism of action, matched by this product’s RxCUI.

🏭 Manufacturer & labeler

LabelerHikma Pharmaceuticals USA Inc.
Application holderWEST-WARD PHARMACEUTICALS INTERNATIONAL LTD
FDA applicationANDA080515 (ANDA)
Labeler code00143
First marketedOct 1971
Product typeHuman Prescription Drug
Portfolio724 products on file
The labeler markets the product; the application holder owns the FDA approval. They’re often the same company but can differ (e.g. a repackager or an authorized generic). A mailing address / phone appears here when the manufacturer includes it in the product’s FDA label (not all do).
Where does this data come from?
Labeler, application holder and registered establishment from the FDA openFDA NDC Directory and Drugs@FDA; address/contact from the product’s FDA label.

🩺 Clinical

Label name CYANOCOBALAMIN 30,000 MCG/30ML Ingredient Cyanocobalamin (Vitamin B-12)
📗 Our plain-language guide HelloPharmacist
  • It's a prescription form of vitamin B12, used when your body can't get enough B12 on its own. That can happen because of a condition called pernicious anemia — where your stomach c...
  • What is cyanocobalamin actually used for?
  • The injection goes directly into a muscle or under the skin, bypassing the gut entirely — which makes it the most reliable option, especially for pernicious anemia, where lifelong...
  • What's the difference between the shot and the nasal spray?
📖 Read our full Cyanocobalamin guide →
Where does this data come from?
Plain-language summary from MedlinePlus (U.S. National Library of Medicine); supplement & herbal interactions and nutrient depletion data from the Natural Medicines database; our full guide is HelloPharmacist editorial content.

🧪 Inactive Ingredients / Excipients

Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.

💡 Tap an ingredient (hover on desktop) to see what it is and why it’s used.

  • UNII LKG8494WBH
    Benzyl alcohol is a clear liquid used as a preservative and solvent in medicines. It helps prevent bacterial and fungal growth and dissolves other ingredients to create uniform liquid formulations.
  • UNII 451W47IQ8X
    Sodium chloride is common table salt. It's used in medicines as a buffer to maintain proper pH, as a filler to add bulk, or to adjust the osmotic balance in liquid formulations.
  • UNII 059QF0KO0R
    Water is a liquid solvent that dissolves and mixes ingredients together in liquid medicines, syrups, and injections. It helps distribute the active drug evenly throughout the product.

3 inactive ingredients listed in the exact product block matched to this NDC.

Where does this data come from?
Data sourced from official FDA Structured Product Labeling (SPL) via DailyMedingredient classCode="IACT" elements from the exact product block matched by this NDC. Label-section narrative from DailyMed / the openFDA label index is shown separately when available.

Inactive ingredient FAQ

Are inactive ingredients the same for every manufacturer?
No. Inactive ingredients can differ by manufacturer, dosage form, strength, and package / product version.
Why might an inactive ingredient be missing?
Some SPLs do not provide a complete structured inactive-ingredient list, and older or unusual labels may only include the information in narrative text.
Can inactive ingredients matter?
Yes. They can matter for allergies, intolerances, dyes, gluten / lactose concerns, preservatives, and formulation differences — but confirm with a pharmacist or the manufacturer when it’s clinically important.

💲 Pricing

A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.

Price systemPer mLPer package
Retail pharmacies payNADAC · weekly $0.794 $23.81 / 30 ml
Medicaid paysCMS SDUD · 12 mo $2.86 $85.68 / 30 ml
Medicare drug plans payPart D · quarterly No Part D plan price is available for this NDC in our data.
Medicare Part B allowsASP · J3420 $0.683 / J3420 unit
NADAC price history (per mL) — tap or hover for the price & month
Jun 2022 Jan 2026 Apr 2026 Aug 2026 $0.986 $0.703
▼ Down 18% over the last 11 months.
Where does this data come from?
NADAC (National Average Drug Acquisition Cost) is the CMS weekly pharmacy-acquisition-cost survey — what pharmacies pay. ASP (Average Sales Price) is the CMS Medicare Part B drug-payment file, published quarterly. Medicaid pays is computed by us from CMS State Drug Utilization Data (total reimbursed ÷ units, trailing 12 months) — gross of rebates and inclusive of dispensing fees, so it reflects what Medicaid paid, not an acquisition cost. Medicare drug plans pay is the median negotiated point-of-sale unit cost across plans listing this NDC in the CMS quarterly Prescription Drug Plan pricing files, before rebates. The VA pays is the federal contract price (FSS, and the statutory Big 4 ceiling where listed) from the VA National Acquisition Center pharmaceutical price file. All are free public government data; each measures a different payer, so the figures are not directly comparable.

🧾 Billing & reimbursement

FDA NDC (as labeled)0143-9619-01
11-digit billing NDC00143-9619-01
Format4-4-2 as registered → padded to 5-4-2 for billing (zero added to the labeler segment)
HCPCS J-codeJ3420
DescriptorInjection, vitamin b-12 cyanocobalamin, up to 1000 mcg
Billing units / pkg30 units
Crosswalk sourceCMS ASP NDC-HCPCS Crosswalk
Where does this data come from?
The HCPCS J-code crosswalk comes from the CMS ASP NDC-HCPCS crosswalk and the DMEPDAC (DME MAC) NDC-HCPCS crosswalk — free public CMS data. Billing units are derived from the code’s descriptor and the package amount.

🔁 Therapeutic equivalents

ProductLabelerPackNADAC/unitTEStatusPrice vs. this
Cyanocobalamin 1000 ug/mL 69680-0121-05 Vitruvias 5 vials $0.549 AP Availability likely save 31%
cyanocobalamin 1000 ug/mL 70710-1665-01 Zydus 1 vial $0.761 AP Availability likely save 4%
Cyanocobalamin 1000 ug/mL 00143-9620-10 Hikma 10 vials $0.777 AP Availability likely save 2%
Cyanocobalamin 1000 ug/mL 69680-0113-99 Vitruvias 10 vials $0.777 AP Availability likely save 2%
cyanocobalamin 1000 ug/mL 70069-0172-10 Somerset 10 vials $0.777 AP Availability likely save 2%
Cyanocobalamin 1000 ug/mL 71288-0301-11 Meitheal 10 vials $0.777 AP Availability likely save 2%
Cyanocobalamin 1000 ug/mLthis 00143-9619-01 Hikma 30 ml $0.794 AP Availability likely
Cyanocobalamin 1000 ug/mL 00517-0130-01 American 1 vial $0.794 AP Availability likely
Cyanocobalamin 1000 ug/mL 71288-0302-30 Meitheal 1 vial $0.794 AP Availability likely
cyanocobalamin 1000 ug/mL 70710-1664-06 Zydus 10 vials $0.819 AP Availability likely +3%
cyanocobalamin 1000 ug/mL 70710-1663-07 Zydus 25 vials $1.491 AP Availability likely +88%
Cyanocobalamin 1000 ug/mL 00143-9621-25 Hikma 25 vials $1.494 AP Availability likely +88%
Cyanocobalamin 1000 ug/mL 00517-0031-25 American 25 vials $1.494 AP Availability likely +88%
Cyanocobalamin 1000 ug/mL 25021-0502-01 Sagent 25 vials $1.494 AP Availability likely +88%
Cyanocobalamin 1000 ug/mL 63323-0044-01 Fresenius 25 vials $1.494 AP Availability likely +88%
Cyanocobalamin 1000 ug/mL 68001-0542-60 BluePoint 25 vials $1.494 AP Availability likely +88%
Cyanocobalamin 1000 ug/mL 68001-0640-60 BluePoint 25 vials $1.494 AP Availability likely +88%
cyanocobalamin 1000 ug/mL 70069-0005-10 Somerset 25 vials $1.494 AP Availability likely +88%
Cyanocobalamin 1000 ug/mL 70512-0840-25 SOLA 25 vials $1.494 AP Availability likely +88%
Cyanocobalamin 1000 ug/mL 71288-0300-92 Meitheal 25 vials $1.494 AP Availability likely +88%
Cyanocobalamin 1000 ug/mL 71288-0303-02 Meitheal 25 vials $1.494 AP Availability likely +88%
Cyanocobalamin 1000 ug/mL 72603-0650-25 NorthStar 25 vials $1.494 AP Availability likely +88%
Cyanocobalamin 1000 ug/mL 00517-0032-25 American 25 vials $2.134 AP Availability likely +169%
Cyanocobalamin 1000 ug/mL 69680-0112-10 Vitruvias 10 vials $2.909 AP Availability likely +267%
Cyanocobalamin 1000 ug/mL 00404-9783-30 Henry 1 vial AP FDA listed
Cyanocobalamin 1000 ug/mL 00404-9786-10 Henry 1 vial AP FDA listed
Cyanocobalamin 1000 ug/mL 50090-6229-00 A-S 25 vials AP FDA listed
Cyanocobalamin 1000 ug/mL 51662-1394-01 HF 30 ml AP FDA listed
Cyanocobalamin 1000 ug/mL 51662-1440-01 HF 10 ml AP FDA listed
Cyanocobalamin 1000 ug/mL 51662-1647-03 HF 25 pouches AP FDA listed
Cyanocobalamin 1000 ug/mL 51662-1703-03 HF 10 pouches AP FDA listed
Cyanocobalamin 1000 ug/mL 55150-0364-01 AuroMedics 1 vial AP FDA listed
Cyanocobalamin 1000 ug/mL 68083-0449-25 Gland 25 vials AP FDA listed
cyanocobalamin 1000 ug/mL 68083-0561-25 Gland 25 vials AP FDA listed
cyanocobalamin 1000 ug/mL 68083-0562-01 Gland 1 vial AP FDA listed
Cyanocobalamin 1000 ug/mL 70069-0171-05 Somerset 5 vials AP FDA listed
Cyanocobalamin 1000 ug/mL 70756-0635-10 Lifestar 10 vials AP FDA listed
Cyanocobalamin 1000 ug/mL 70756-0636-10 Lifestar 10 vials AP FDA listed
Cyanocobalamin 1000 ug/mL 70756-0637-05 Lifestar 5 vials AP FDA listed
cyanocobalamin 1000 ug/mL 70771-1688-07 Zydus 25 vials AP FDA listed
cyanocobalamin 1000 ug/mL 70771-1689-06 Zydus 10 vials AP FDA listed
cyanocobalamin 1000 ug/mL 70771-1690-01 Zydus 1 vial AP FDA listed
cyanocobalamin 1000 ug/mL 76420-0075-25 Asclemed 25 vials AP FDA listed
Cyanocobalamin 1000 ug/mL 76420-0111-25 Asclemed 25 vials AP FDA listed
Cyanocobalamin 1000 ug/mL 76420-0618-25 Asclemed 25 vials AP FDA listed
cyanocobalamin 1000 ug/mL 85766-0029-25 Sportpharm 25 vials AP FDA listed
Cyanocobalamin 1000 ug/mL 87188-0111-90 Plano 25 vials AP FDA listed
cyanocobalamin 1000 ug/mL 87188-0112-01 Plano 1 vial AP FDA listed
cyanocobalamin 1000 ug/mL 87188-0113-01 Plano 1 vial AP FDA listed
About this product: this is a generic version of the medicine. FDA equivalence ratings are shown when available, and other versions are listed above, least expensive first.
Where does this data come from?
Equivalents are other NDCs of the same ingredient, form and route from the openFDA NDC Directory, ranked least-expensive-first by NADAC. Therapeutic-equivalence (AB) ratings come from the FDA Orange Book; biologics use the FDA Purple Book for biosimilar & interchangeable status.

Availability & generic status

🏛️
1971
On the market since
Oct 1971
📍
2026
Currently FDA-listed
55 years listed
🔓
·
Generic on the market
this product is a generic
This is a generic drug

This product is an FDA-approved generic. Other versions of the same drug are listed under Therapeutic equivalents, least expensive first.

Where does this data come from?
Patents and exclusivity from the FDA Orange Book (small-molecule drugs), refreshed from public FDA data. Generic launch timing is an estimate, not a guarantee.

🗺️ Medicaid utilization & spend

📍 This exact package only: Medicaid data is reported per full 11-digit NDC — labeler, product and pack size — so every number here is for 00143-9619-01, not the drug overall. Other pack sizes report separately.
💊 Pharmacy benefit only: These are Medicaid outpatient pharmacy claims, billed by NDC. They exclude the medical benefit — clinic- or hospital-administered drugs billed under HCPCS J-codes — so drugs used mostly that way (e.g. Avastin, Lucentis, Keytruda) can look low or missing here. That’s expected, not an error.
📅 Q1 2025 – Q4 2025 · 4 quarters of data
ⓘ The newest quarter is usually incomplete when first published; states restate recent quarters in later CMS releases, so the latest figures typically revise upward. State coverage-policy changes can also shift quarter-to-quarter totals.
Prescriptions last 4 qtrs
10.6K
Units reimbursed last 4 qtrs
11.6K
Gross reimbursed last 4 qtrs
$33.1K
Avg / prescription
$3.12
Avg / unit
$2.8560
Latest quarter Q4 2025
1.9KRx
Medicaid pays / mL
$2.8560
gross reimbursed
vs
NADAC / mL
$0.7938
acquisition cost
=
Spread
+$2.0622
+260% vs cost
What Medicaid paid per mL (before rebates; includes the pharmacy’s dispensing fee) compared with NADAC — the average price pharmacies pay to buy the drug. A positive spread means Medicaid reimbursed more than the purchase price, before manufacturer rebates.
Fee-for-service vs managed care
30% FFS 70% MCO
Fee-for-service · 3,216 Rx Managed care · 7,404 Rx
State Medicaid map
Alaska: no data reported AK Maine: no data reported ME Washington: no data reported WA Idaho: no data reported ID Montana: no data reported MT North Dakota: no data reported ND Minnesota: 15 units · 0.3 per 100k residents MN Wisconsin: no data reported WI Michigan: no data reported MI New York: 2,880 units · 14.7 per 100k residents NY Vermont: no data reported VT New Hampshire: no data reported NH Oregon: no data reported OR Nevada: 200 units · 6.3 per 100k residents NV Wyoming: no data reported WY South Dakota: no data reported SD Iowa: no data reported IA Illinois: 855 units · 6.8 per 100k residents IL Indiana: 128 units · 1.9 per 100k residents IN Ohio: 67 units · 0.6 per 100k residents OH Pennsylvania: 77 units · 0.6 per 100k residents PA New Jersey: 595 units · 6.4 per 100k residents NJ Massachusetts: 29 units · 0.4 per 100k residents MA California: 1,244 units · 3.2 per 100k residents CA Utah: no data reported UT Colorado: 324 units · 5.5 per 100k residents CO Nebraska: no data reported NE Missouri: no data reported MO Kentucky: 359 units · 7.9 per 100k residents KY West Virginia: no data reported WV Virginia: 222 units · 2.5 per 100k residents VA Maryland: 71 units · 1.1 per 100k residents MD Connecticut: no data reported CT Rhode Island: no data reported RI Arizona: 1,360 units · 18.3 per 100k residents AZ New Mexico: 3 units · 0.1 per 100k residents NM Kansas: no data reported KS Arkansas: 13 units · 0.4 per 100k residents AR Tennessee: 659 units · 9.2 per 100k residents TN North Carolina: 365 units · 3.4 per 100k residents NC South Carolina: no data reported SC Delaware: no data reported DE Oklahoma: no data reported OK Louisiana: 23 units · 0.5 per 100k residents LA Mississippi: 74 units · 2.5 per 100k residents MS Alabama: 432 units · 8.5 per 100k residents AL Georgia: 117 units · 1.1 per 100k residents GA D.C.: no data reported DC Hawaii: no data reported HI Texas: 285 units · 0.9 per 100k residents TX Florida: 1,200 units · 5.3 per 100k residents FL
Units reimbursed · per 100k residents
0.118.3
gray = no data reported
Colors are per 100,000 residents, so big states don’t automatically dominate. Tap or hover a state for its actual totals.
Tap or hover a state
…for its Medicaid breakdown
🏆 Top states by units · per 100k residents
1 Arizona 18.3 /100k
2 New York 14.7 /100k
3 Tennessee 9.2 /100k
4 Alabama 8.5 /100k
5 Kentucky 7.9 /100k
6 Illinois 6.8 /100k
7 New Jersey 6.4 /100k
8 Nevada 6.3 /100k
National units — by quarter
💵 About the dollar figures: “reimbursed” is what Medicaid paid pharmacies before confidential manufacturer rebates, so the program’s real net cost is lower than these numbers. Fee-for-service and managed-care claims are combined unless split above. Source: CMS State Drug Utilization Data; per-100k rates use 2023 Census population estimates.

💊 Medicaid utilization by pack size

Medicaid (SDUD) totals over the four most recent reported quarters for every package size of this drug — handy when a specific package (e.g. a starter/titration pack) carries little or no Medicaid volume on its own.
10 vials00143-9619-10 15,788 Rx · $29,729
3 ml this page00143-9619-01 10,620 Rx · $33,118
Drug total (last 4 qtrs): 26,408 Rx · 30,888 units · $62,848 gross reimbursed
Tap a pack size to open its page. Source: CMS State Drug Utilization Data, last 4 quarters.

🔬 Reported adverse events (FAERS)

Read carefully: FAERS reports are voluntary and unverified. Counts are not incidence, do not establish causation, are subject to reporting bias, and cannot be used to compare one drug to another. Shown for signal context only. Reports for Cyanocobalamin — the ingredient across all brands.

Top reported reactions

Fatigue3,429
Nausea2,832
Headache2,445
Pain2,324
Diarrhoea2,292
Dyspnoea2,190
Vomiting1,857

Age at onset

Neonate10
Infant7
Child18
Adolescent36
Adult3,397
Elderly3,703

Reporter sex

34,374 reports
Male · 35%
Female · 65%
Unknown · 0%

Serious outcomes

Hospitalization13,775
Death3,418
Disabling1,753
Reports over time (by year) — tap or hover for the count & year
2019 2021 2023 2026 3,306 0
Most recent year is provisional (FAERS lags ~3 months).
Where does this data come from?
Adverse-event reports from the FDA Adverse Event Reporting System (FAERS) via openFDA. FAERS reports are voluntary and unverified — counts are not incidence and don’t establish causation.

📦 Packaging — all sizes for this product

Package NDCDescription Per unit Per pack Marketing startStatus
00143-9619-10 10 VIAL, MULTI-DOSE in 1 BOX (0143-9619-10) / 30 mL in 1 VIAL, MULTI-DOSE (0143-9619-01) $0.3281 / mL $98.42 1971-10-20 Active
00143-9619-01 You're viewing this 30 mL in 1 VIAL, MULTI-DOSE (0143-9619-01) $0.7938 / mL $23.81 1971-10-20 Active

Per mL, this pack runs about 142% above the cheapest pack (NDC 00143-9619-10, $0.3281 vs $0.7938 NADAC).

This pack accounts for about 40% of this product's recent Medicaid fills; most go to a different pack size. See all packs ↓

Pack size FAQ

What quantity is in NDC 00143-9619-01?
NDC 00143-9619-01 contains 30 mL — 30 ml in 1 vial, multi-dose.
What NDC number is used to bill for this package of Cyanocobalamin 1000 ug/mL Injection?
Bill NDC 00143-9619-01 — the 11-digit billing format is 00143961901. Pharmacy and medical claims use the 11-digit form; the FDA label may print a shorter form of the same code.

Prices are the latest CMS NADAC pharmacy acquisition cost per NDC; per-pack figures are per-unit × pack quantity, shown only when the pack is denominated in the same measure NADAC prices.

📄 Full prescribing information FDA SPL

The complete FDA label for this product — the official prescribing information, verbatim, section by section. Jump with a chip, search within the label, or expand everything.
🎯 Indications and Usage 160 words

INDICATIONS AND USAGE Cyanocobalamin is indicated for vitamin B 12 deficiencies due to malabsorption which may be associated with the following conditions: Addisonian (pernicious) anemia Gastrointestinal pathology, dysfunction, or surgery, including gluten enteropathy or sprue, small bowel bacteria overgrowth, total or partial gastrectomy Fish tapeworm infestation Malignancy of pancreas or bowel Folic acid deficiency It may be possible to treat the underlying disease by surgical correction of anatomic lesions leading to small bowel bacterial overgrowth, expulsion of fish tapeworm, discontinuation of drugs leading to vitamin malabsorption (see Drug Interactions ), use of a gluten-free diet in nontropical sprue, or administration of antibiotics in tropical sprue.

Such measures remove the need for long-term administration of cyanocobalamin. Requirements of vitamin B 12 in excess of normal (due to pregnancy, thyrotoxicosis, hemolytic anemia, hemorrhage, malignancy, hepatic and renal disease) can usually be met with oral supplementation. Cyanocobalamin Injection, USP is also suitable for the vitamin B 12 absorption test ( Schilling test ).

⏱️ Dosage and Administration 218 words

DOSAGE AND ADMINISTRATION Avoid using the intravenous route. Use of this product intravenously will result in almost all of the vitamin being lost in the urine. Pernicious Anemia Parenteral vitamin B 12 is the recommended treatment and will be required for the remainder of the patient's life.

The oral form is not dependable. A dose of 100 mcg daily for 6 or 7 days should be administered by intramuscular or deep subcutaneous injection. If there is clinical improvement and if a reticulocyte response is observed, the same amount may be given on alternate days for seven doses, then every 3 to 4 days for another 2 to 3 weeks.

By this time hematologic values should have become normal. This regimen should be followed by 100 mcg monthly for life. Folic acid should be administered concomitantly if needed.

Patients with Normal Intestinal Absorption Where the oral route is not deemed adequate, initial treatment similar to that for patients with pernicious anemia may be indicated depending on the severity of the deficiency. Chronic treatment should be with an oral B 12 preparation. If other vitamin deficiencies are present, they should be treated.

Schilling Test The flushing dose is 1000 mcg. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.

Contraindications 11 words

CONTRAINDICATIONS Sensitivity to cobalt and/or vitamin B 12 is a contraindication.

⚠️ Warnings 182 words

WARNINGS Patients with early Leber's disease (hereditary optic nerve atrophy) who were treated with cyanocobalamin suffered severe and swift optic atrophy. Hypokalemia and sudden death may occur in severe megaloblastic anemia which is treated intensely. Anaphylactic shock and death have been reported after parenteral vitamin B 12 administration.

An intradermal test dose is recommended before Cyanocobalamin Injection, USP is administered to patients suspected of being sensitive to this drug. This product contains Benzyl Alcohol. Benzyl Alcohol has been reported to be associated with a fatal "Gasping Syndrome" in premature infants.

This product contains aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which contain aluminum.

Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 mcg/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity. Tissue loading may occur at even lower rates of administration.

🤒 Adverse Reactions 51 words

ADVERSE REACTIONS Generalized Anaphylactic shock and death have been reported with administration of parenteral vitamin B 12 (see WARNINGS ). Cardiovascular Pulmonary edema and congestive heart failure early in treatment; peripheral vascular thrombosis. Hematological Polycythemia vera Gastrointestinal Mild transient diarrhea Dermatological Itching; transitory exanthema Miscellaneous Feeling of swelling of entire body

🔄 Drug / Laboratory Test Interactions 40 words

Drug/Laboratory Test Interactions Persons taking most antibiotics, methotrexate and pyrimethamine invalidate folic acid and vitamin B 12 diagnostic blood assays. Colchicine para-aminosalicylic acid and heavy alcohol intake for longer than 2 weeks may produce malabsorption of vitamin B 12 .

🤰 Pregnancy 62 words

Pregnancy Teratogenic Effects: Pregnancy Category C Adequate and well-controlled studies have not been done in pregnant women. However, vitamin B 12 is an essential vitamin and requirements are increased during pregnancy. Amounts of vitamin B 12 that are recommended by the Food and Nutrition Board, National Academy of Science-National Research Council for pregnant women (4 mcg daily) should be consumed during pregnancy.

🧒 Pediatric Use 28 words

Pediatric Use Intake in children should be in the amount (0.5 to 3 mcg daily) recommended by the Food and Nutrition Board, National Academy of Science-National Research Council.

🆘 Overdosage 9 words

OVERDOSAGE No overdosage has been reported with this drug.

🧬 Clinical Pharmacology ~2 min read

CLINICAL PHARMACOLOGY Vitamin B 12 is essential to growth, cell reproduction, hematopoiesis, and nucleoprotein and myelin synthesis. Cyanocobalamin is quantitatively and rapidly absorbed from intramuscular and subcutaneous sites of injection; the plasma level of the compound reaches its peak within 1 hour after intramuscular injection. Absorbed vitamin B 12 is transported via specific B 12 binding proteins, transcobalamin I and II to the various tissues.

The liver is the main organ for vitamin B 12 storage. Within 48 hours after injection of 100 or 1000 mcg of vitamin B 12 , 50 to 98% of the injected dose may appear in the urine. The major portion is excreted within the first eight hours.

Intravenous administration results in even more rapid excretion with little opportunity for liver storage. Gastrointestinal absorption of vitamin B 12 depends on the presence of sufficient intrinsic factor and calcium ions. Intrinsic factor deficiency causes pernicious anemia, which may be associated with subacute combined degeneration of the spinal cord.

Prompt parenteral administration of vitamin B 12 prevents progression of neurologic damage. The average diet supplies about 5 to 15 mcg/day of vitamin B 12 in a protein-bound form that is available for absorption after normal digestion. Vitamin B 12 is not present in foods of plant origin, but is abundant in foods of animal origin.

In people with normal absorption, deficiencies have been reported only in strict vegetarians who consume no products of animal origin (including no milk products or eggs). Vitamin B 12 is bound to intrinsic factor during transit through the stomach; separation occurs in the terminal ileum in the presence of calcium, and vitamin B 12 enters the mucosal cell for absorption. It is then transported by the transcobalamin binding proteins.

A small amount (approximately 1% of the total amount ingested) is absorbed by simple diffusion, but this mechanism is adequate only with very large doses. Oral absorption is considered too undependable to rely on in patients with pernicious anemia or other conditions resulting in malabsorption of vitamin B 12 . Cyanocobalamin is the most widely used form of vitamin B 12 , and has hematopoietic activity apparently identical to that of the antianemia factor in purified liver extract.

Hydroxycobalamin is equally as effective as cyanocobalamin, and they share the cobalamin molecular structure.

📦 How Supplied / Storage and Handling 141 words

HOW SUPPLIED Cyanocobalamin Injection, USP 1000 mcg/mL is available in the following packages: NDC 0143-9621-25 1 mL Vial Boxes of 25 Vials NDC 0143-9620-10 10 mL Multiple Dose Vial Boxes of 10 Vials NDC 0143-9619-10 30 mL Multiple Dose Vial Boxes of 10 Vials NDC 0143-9619-01 30 mL Multiple Dose Vial Box of 1 Vial Storage Store at 20° to 25°C (68° to 77°F); excursions permitted to 15° to 30°C (59° to 86°F) [See USP Controlled Room Temperature]. PROTECT FROM LIGHT. To report SUSPECTED ADVERSE REACTIONS, contact Hikma Pharmaceuticals USA Inc. at 1-877-845-0689, or the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

For Product Inquiry call 1-877-845-0689. Manufactured by: HIKMA FARMACÊUTICA (PORTUGAL), S.A. Estrada do Rio da Mό, 8, 8A e 8B – Fervença – 2705-906 Terrugem SNT, PORTUGAL Distributed by: Hikma Pharmaceuticals USA Inc.

Berkeley Heights, NJ 07922 Revised December 2023 PIN350-WES/6

📦 Storage and Handling 86 words

Storage Store at 20° to 25°C (68° to 77°F); excursions permitted to 15° to 30°C (59° to 86°F) [See USP Controlled Room Temperature]. PROTECT FROM LIGHT. To report SUSPECTED ADVERSE REACTIONS, contact Hikma Pharmaceuticals USA Inc. at 1-877-845-0689, or the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

For Product Inquiry call 1-877-845-0689. Manufactured by: HIKMA FARMACÊUTICA (PORTUGAL), S.A. Estrada do Rio da Mό, 8, 8A e 8B – Fervença – 2705-906 Terrugem SNT, PORTUGAL Distributed by: Hikma Pharmaceuticals USA Inc.

Berkeley Heights, NJ 07922 Revised December 2023 PIN350-WES/6

📋 Description 132 words

DESCRIPTION Cyanocobalamin Injection (vitamin B 12 ) is a sterile solution of Cyanocobalamin. Each mL contains Cyanocobalamin 1000 mcg, sodium chloride 9 mg and benzyl alcohol 0.015 mL in water for injection. Hydrochloric acid and/or sodium hydroxide may have been added to adjust the pH (range 4.5-7.0).

Cyanocobalamin appears as dark red crystals or as an amorphous or crystalline red powder. It is very hygroscopic in the anhydrous form, and sparingly soluble in water (1:80). It is stable to autoclaving for short periods at 121°C.

The vitamin B 12 coenzymes are very unstable in light. The chemical name is 5,6-dimethyl-benzimidazolyl cyanocobamide; the molecular formula is C 63 H 88 CoN 14 O 14 P. The cobalt content is 4.34%.

The molecular weight is 1355.39. The structural formula is represented below. Structural Formula

💬 Information for Patients 157 words

Information for Patients Patients with pernicious anemia should be informed that they will require monthly injections of vitamin B 12 for the remainder of their lives. Failure to do so will result in return of the anemia and in development of incapacitating and irreversible damage to the nerves of the spinal cord. Also, patients should be warned about the danger of taking folic acid in place of vitamin B 12 , because the former may prevent anemia but allow progression of subacute combined degeneration.

A vegetarian diet which contains no animal products (including milk products or eggs) does not supply any vitamin B 12 . Patients following such a diet, should be advised to take oral vitamin B 12 regularly. The need for vitamin B 12 is increased by pregnancy and lactation.

Deficiency has been recognized in infants of vegetarian mothers who were breast fed, even though the mothers had no symptoms of deficiency at the time.

Source: FDA Structured Product Labeling, mirrored from DailyMed / openFDA. Prefer the government’s original formatting? View this label on DailyMed ↗
For educational and professional reference only — not medical advice. Pricing reflects published NADAC and CMS ASP (free public data) and may differ from your acquisition cost; always verify before billing or dispensing.