HomeNDC LookupIngredientsCyanocobalamin › 69680-0121-05
Cyanocobalamin 1000 ug/mL Injection, Solution — NDC 69680-0121-05 package photo

Cyanocobalamin 1000 ug/mL Injection, Solution

by Vitruvias Therapeutics · 5 VIAL, MULTI-DOSE in 1 BOX (69680-121-05) / 30 mL in 1 VIAL, MULTI-DOSE
NDC 69680-0121-05
🏷️ FDA NDC (as labeled) 69680-121-05 billing pads the product segment with a zero
This package
Contains30 mL in 1 vial, multi-dose Cost per mL$0.5488 NADAC Per package$82.32 / 150 ml Pack sizes3 compare ↓
Also priced by: Medicaid pays $11.73/unit — full pricing hub ↓
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) 69680-121-05
Product NDC 69680-121
11-digit billing NDC 69680012105
NCPDP billing unit ML — per mL (volume)
RxCUI 309594
UNII P6YC3EG204
Application # ANDA209255
SPL Set ID 2117af8a-723f-4e2f-98a6-83ad2c423751
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 2020-02-12
Route INTRAMUSCULAR
Dosage form INJECTION, SOLUTION
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 69680-121-05 — a 5-3-2 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 product segment → 69680-0121-05. 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

LabelerVitruvias Therapeutics
Application holderVITRUVIAS THERAPEUTICS LLC
FDA applicationANDA209255 (ANDA)
Labeler code69680
First marketedFeb 2020
Product typeHuman Prescription Drug
Portfolio16 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
  • Great question. The reason your doctor chose the injection is that your body can't absorb B12 properly through the digestive tract — whether that's because of pernicious anemia, a...
  • Why do I need an injection instead of just taking a B12 pill?
  • It depends on why you need B12 in the first place. If you have pernicious anemia, you'll typically start with more frequent injections — daily at first, then spacing out over sever...
  • Most people do fine with these injections. You might notice mild, short-lived diarrhea, some itching, or a temporary skin rash. A general feeling of body swelling has also been rep...
📖 Read our full Cyanocobalamin Injection 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.

💊 What it looks like

Color Red
One label can cover several strengths, so colors may be combined — always confirm a loose pill against the dispensed prescription label or a pharmacist.
Where does this data come from?
Physical description (imprint, shape, color, scoring, coating) from this product’s FDA Structured Product Labeling (SPL), mirrored from DailyMed / openFDA.

🧪 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 $0.549 $82.32 / 150 ml
Medicaid paysCMS SDUD · 12 mo $11.73 $1,759.91 / 150 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
Dec 2025 Feb 2026 May 2026 Aug 2026 $0.562 $0.493
▼ Down 2% over the last 8 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)69680-121-05
11-digit billing NDC69680-0121-05
Format5-3-2 as registered → padded to 5-4-2 for billing (zero added to the product segment)
HCPCS J-codeJ3420
DescriptorINJECTION, VITAMIN B-12 CYANOCOBALAMIN, UP TO 1000 MCG
Billing units / pkg1 units
Crosswalk sourcePDAC NDC-HCPCS crosswalk (DME MAC / DMEPOS)
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 00143-9619-10 Hikma 10 vials $0.328 AP Availability likely save 40%
Cyanocobalamin 1000 ug/mLthis 69680-0121-05 Vitruvias 5 vials $0.549 AP Availability likely
cyanocobalamin 1000 ug/mL 70710-1665-01 Zydus 1 vial $0.761 AP Availability likely +39%
Cyanocobalamin 1000 ug/mL 00143-9620-10 Hikma 10 vials $0.777 AP Availability likely +42%
Cyanocobalamin 1000 ug/mL 69680-0113-99 Vitruvias 10 vials $0.777 AP Availability likely +42%
cyanocobalamin 1000 ug/mL 70069-0172-10 Somerset 10 vials $0.777 AP Availability likely +42%
Cyanocobalamin 1000 ug/mL 71288-0301-11 Meitheal 10 vials $0.777 AP Availability likely +42%
Cyanocobalamin 1000 ug/mL 00517-0130-01 American 1 vial $0.794 AP Availability likely +45%
Cyanocobalamin 1000 ug/mL 71288-0302-30 Meitheal 1 vial $0.794 AP Availability likely +45%
cyanocobalamin 1000 ug/mL 70710-1664-06 Zydus 10 vials $0.819 AP Availability likely +49%
cyanocobalamin 1000 ug/mL 70710-1663-07 Zydus 25 vials $1.491 AP Availability likely +172%
Cyanocobalamin 1000 ug/mL 00143-9621-25 Hikma 25 vials $1.494 AP Availability likely +172%
Cyanocobalamin 1000 ug/mL 00517-0031-25 American 25 vials $1.494 AP Availability likely +172%
Cyanocobalamin 1000 ug/mL 25021-0502-01 Sagent 25 vials $1.494 AP Availability likely +172%
Cyanocobalamin 1000 ug/mL 63323-0044-01 Fresenius 25 vials $1.494 AP Availability likely +172%
Cyanocobalamin 1000 ug/mL 68001-0542-60 BluePoint 25 vials $1.494 AP Availability likely +172%
Cyanocobalamin 1000 ug/mL 68001-0640-60 BluePoint 25 vials $1.494 AP Availability likely +172%
cyanocobalamin 1000 ug/mL 70069-0005-10 Somerset 25 vials $1.494 AP Availability likely +172%
Cyanocobalamin 1000 ug/mL 70512-0840-25 SOLA 25 vials $1.494 AP Availability likely +172%
Cyanocobalamin 1000 ug/mL 71288-0300-92 Meitheal 25 vials $1.494 AP Availability likely +172%
Cyanocobalamin 1000 ug/mL 71288-0303-02 Meitheal 25 vials $1.494 AP Availability likely +172%
Cyanocobalamin 1000 ug/mL 72603-0650-25 NorthStar 25 vials $1.494 AP Availability likely +172%
Cyanocobalamin 1000 ug/mL 00517-0032-25 American 25 vials $2.134 AP Availability likely +289%
Cyanocobalamin 1000 ug/mL 69680-0112-10 Vitruvias 10 vials $2.909 AP Availability likely +430%
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

🏛️
2020
On the market since
Feb 2020
📍
2026
Currently FDA-listed
6 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 69680-0121-05, 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
1.1K
Units reimbursed last 4 qtrs
1.4K
Gross reimbursed last 4 qtrs
$16.9K
Avg / prescription
$15.35
Avg / unit
$11.7327
Latest quarter Q4 2025
230Rx
Medicaid pays / mL
$11.7327
gross reimbursed
vs
NADAC / mL
$0.5488
acquisition cost
=
Spread
+$11.1839
+2038% 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
51% FFS 49% MCO
Fee-for-service · 562 Rx Managed care · 541 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: no data reported MN Wisconsin: no data reported WI Michigan: no data reported MI New York: 772 units · 3.9 per 100k residents NY Vermont: no data reported VT New Hampshire: no data reported NH Oregon: no data reported OR Nevada: no data reported NV Wyoming: no data reported WY South Dakota: no data reported SD Iowa: no data reported IA Illinois: 71 units · 0.6 per 100k residents IL Indiana: no data reported IN Ohio: no data reported OH Pennsylvania: no data reported PA New Jersey: 128 units · 1.4 per 100k residents NJ Massachusetts: no data reported MA California: 36 units · 0.1 per 100k residents CA Utah: no data reported UT Colorado: no data reported CO Nebraska: no data reported NE Missouri: no data reported MO Kentucky: no data reported KY West Virginia: 177 units · 10.0 per 100k residents WV Virginia: no data reported VA Maryland: no data reported MD Connecticut: no data reported CT Rhode Island: no data reported RI Arizona: no data reported AZ New Mexico: no data reported NM Kansas: no data reported KS Arkansas: no data reported AR Tennessee: no data reported TN North Carolina: 21 units · 0.2 per 100k residents NC South Carolina: no data reported SC Delaware: no data reported DE Oklahoma: no data reported OK Louisiana: no data reported LA Mississippi: no data reported MS Alabama: no data reported AL Georgia: 213 units · 1.9 per 100k residents GA D.C.: no data reported DC Hawaii: no data reported HI Texas: no data reported TX Florida: 25 units · 0.1 per 100k residents FL
Units reimbursed · per 100k residents
0.110.0
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 West Virginia 10.0 /100k
2 New York 3.9 /100k
3 Georgia 1.9 /100k
4 New Jersey 1.4 /100k
5 Illinois 0.6 /100k
6 North Carolina 0.2 /100k
7 Florida 0.1 /100k
8 California 0.1 /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.
1 vial69680-0121-30 4,607 Rx · $13,818
5 vials this page69680-0121-05 1,103 Rx · $16,930
10 vials69680-0121-10 No Medicaid data
Drug total (last 4 qtrs): 5,710 Rx · 6,160 units · $30,749 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
69680-0121-05 You're viewing this 5 VIAL, MULTI-DOSE in 1 BOX (69680-121-05) / 30 mL in 1 VIAL, MULTI-DOSE $0.5488 / mL $82.31 2020-02-12 Active
69680-0121-10 10 VIAL, MULTI-DOSE in 1 BOX (69680-121-10) / 30 mL in 1 VIAL, MULTI-DOSE $0.3281 / mL $98.42 2021-09-15 Active
69680-0121-30 1 VIAL, MULTI-DOSE in 1 BOX (69680-121-30) / 30 mL in 1 VIAL, MULTI-DOSE $0.7938 / mL $23.81 2021-09-15 Active

Per mL, this pack runs about 67% above the cheapest pack (NDC 69680-0121-10, $0.3281 vs $0.5488 NADAC).

This pack accounts for about 19% 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 69680-0121-05?
NDC 69680-0121-05 is listed by the FDA — 5 vial, multi-dose in 1 box / 30 ml in 1 vial, multi-dose.
What NDC number is used to bill for this package of Cyanocobalamin 1000 ug/mL Injection, Solution?
Bill NDC 69680-0121-05 — the 11-digit billing format is 69680012105. 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 155 words

INDICATIONS AND USAGE Cyanocobalamin is indicated for vitamin B12 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 B12 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 B12 absorption test (Schilling test).

⏱️ Dosage and Administration 216 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 B12 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 B12 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 10 words

CONTRAINDICATIONS Sensitivity to cobalt and/or vitamin B12 is a contraindication.

⚠️ Warnings 181 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 B12 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 66 words

ADVERSE REACTIONS Generalized: Anaphylactic shock and death have been reported with administration of parenteral vitamin B12 (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 To report SUSPECTED ADVERSE REACTIONS, contact Vitruvias Therapeutics at 1-844-451-5944 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

🔄 Drug / Laboratory Test Interactions 37 words

Drug/Laboratory Test Interactions Persons taking most antibiotics, methotrexate and pyrimethamine invalidate folic acid and vitamin B12 diagnostic blood assays. Colchicine, para-aminosalicylic acid and heavy alcohol intake for longer than 2 weeks may produce malabsorption of vitamin B12.

🤰 Pregnancy 60 words

Pregnancy Teratogenic Effects Pregnancy Category C Adequate and well-controlled studies have not been done in pregnant women. However, vitamin B12 is an essential vitamin and requirements are increased during pregnancy. Amounts of vitamin B12 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 B12 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 B12 is transported via specific B12 binding proteins, transcobalamin I and II to the various tissues.

The liver is the main organ for vitamin B12 storage. Within 48 hours after injection of 100 or 1000 mcg of vitamin B12, 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 B12 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 B12 prevents progression of neurologic damage. The average diet supplies about 5 to 15 mcg/day of vitamin B12 in a protein-bound form that is available for absorption after normal digestion. Vitamin B12 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 B12 is bound to intrinsic factor during transit through the stomach; separation occurs in the terminal ileum in the presence of calcium, and vitamin B12 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 B12. Cyanocobalamin is the most widely used form of vitamin B12, 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 88 words

HOW SUPPLIED Cyanocobalamin Injection, USP 1000 mcg/mL NDC 69680-112-10 1 mL Vial Boxes of 10 NDC 69680-112-25 1 mL Vial Boxes of 25 NDC 69680-113-99 10 mL Multiple Dose Vial Boxes of 10 NDC 69680-121-30 30 mL Multiple Dose Vial Boxes of 1 NDC 69680-121-05 30 mL Multiple Dose Vial Boxes of 5 NDC 69680-121-10 30 mL Multiple Dose Vial Boxes of 10 Store at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature]. PROTECT FROM LIGHT Use only if solution is clear and seal intact.

📦 Storage and Handling 25 words

Store at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature]. PROTECT FROM LIGHT Use only if solution is clear and seal intact.

📋 Description 142 words

DESCRIPTION Cyanocobalamin Injection, USP is a sterile solution of cyanocobalamin for intramuscular or subcutaneous injection. Each mL contains 1000 mcg cyanocobalamin. Each vial also contains Sodium Chloride, 0.9%.

Benzyl Alcohol, 1.5%, is present as a preservative and Water for Injection q.s. Hydrochloric acid and/or sodium hydroxide may have been added during manufacture 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 B12 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. Chemical Structure

💬 Information for Patients 150 words

Information for Patients Patients with pernicious anemia should be informed that they will require monthly injections of vitamin B12 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 B12, 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 B12. Patients following such a diet, should be advised to take oral vitamin B12 regularly. The need for vitamin B12 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.