Pharmacy No. 84. Delivery of medicines to your home and office.

Medicines

my basket

Apteka84.kz is an online pharmacy that offers its customers medicines, medicinal and decorative cosmetics, dietary supplements, vitamins, baby food, intimate products for adults, medical equipment and thousands of other medical and cosmetic products at low prices. All data presented on the Apteka84.kz website is for informational purposes only and is not a substitute for professional medical care. Apteka84.kz strongly recommends that you carefully read the instructions for use contained in each package of medicines and other products. If you currently have any symptoms of the disease, you should seek help from a doctor. You should always tell your doctor or pharmacist about all the medicines you take. If you feel you need further help, please consult your local pharmacist or contact our GP online or by telephone.

Instructions for use CYANOCOBALAMIN

Adults.

SC for Addison-Birmer anemia - 100-200 mcg/day every other day; for funicular myelosis, macrocytic anemia with dysfunction of the nervous system - 400-500 mcg/day in the first week - daily, then at intervals between administrations of up to 5-7 days (folic acid is prescribed at the same time); during the period of remission, a maintenance dose of 100 mcg/day 2 times a month, in the presence of neurological phenomena - 200-400 mcg 2-4 times a month.

For acute posthemorrhagic and iron deficiency anemia - 30-100 mcg 2-3 times a week, for aplastic anemia - 100 mcg until clinical and hematological improvement occurs.

For diseases of the central and peripheral nervous system, neurological diseases with pain, it is administered in increasing doses - 200-500 mcg/day until pain relief, then 100 mcg/day for 2 weeks. For traumatic lesions of the peripheral nervous system - 200-400 mcg every other day for 40-45 days.

For hepatitis and cirrhosis of the liver - 30-60 mcg/day or 100 mcg every other day for 25-40 days.

For acute radiation sickness, diabetic neuropathy - 60-100 mcg daily for 20-30 days.

For funicular myelosis, amyotrophic lateral sclerosis, multiple sclerosis - 15-30 mcg intralumbarally, and with each subsequent injection the dose is increased (50, 100, 150, 200 mcg). Intralumbar injections are given every 3 days, a total of 8-10 injections are required per course. During the period of remission in the absence of manifestations of funicular myelosis, 100 mcg twice a month is prescribed for maintenance therapy, in the presence of neurological symptoms - 200-400 mcg 2-4 times a month.

To eliminate cyanocobalamin deficiency, the following is administered intramuscularly or intravenously:

for treatment 1 mg daily for 1-2 weeks, maintenance dose 1-2 mg from 1 time per week to 1 time per month;
for prevention - 1 mg once a month. The duration of treatment is determined individually.

Children.

Administered subcutaneously at a dose of 1 mcg/kg, the maximum daily dose is 100 mcg. For nutritional anemia and anemia in premature infants - subcutaneously 30 mcg per day daily for 15 days, for aplastic anemia - 100 mcg until clinical and hematological improvement occurs.

For degenerative conditions after illness, Down's disease and cerebral palsy - 15-30 mcg subcutaneously every other day.

For hepatitis and cirrhosis of the liver, take 30-60 mcg/day or 100 mcg every other day for 25-40 days.

Doses and regimen of use depend on the pathology and range from 30 mcg to 100 mcg/day. The 500 mcg/ml dosage form is not used in children under 3 years of age.

Cyanocobalamin, solution

Cyanocobalamin is administered subcutaneously, intramuscularly, intravenously, and for funicular myelosis and amyotrophic lateral sclerosis - intralumbarally.

Adults

Subcutaneously for Addison-Biermer anemia – 100–200 mcg/day every other day; for funicular myelosis, macrocytic anemia with dysfunction of the nervous system - 400-500 mcg/day in the first week - daily, then at intervals between administrations of up to 5-7 days (folic acid is prescribed at the same time); during the period of remission, a maintenance dose of 100 mcg/day 2 times a month, in the presence of neurological phenomena - 200-400 mcg 2–4 times a month.

For acute posthemorrhagic and iron deficiency anemia - 30-100 mcg 2-3 times a week, for aplastic anemia - 100 mcg until clinical and hematological improvement occurs.

For diseases of the central and peripheral nervous system, neurological diseases with pain, it is administered in increasing doses - 200–500 mcg/day until pain relief, then 100 mcg/day for 2 weeks. For traumatic lesions of the peripheral nervous system - 200–400 mcg every other day for 40–45 days.

For hepatitis and cirrhosis of the liver - 30–60 mcg/day or 100 mcg every other day for 25–40 days.

For acute radiation sickness, diabetic neuropathy – 60–100 mcg daily for 20–30 days.

For funicular myelosis, amyotrophic lateral sclerosis, multiple sclerosis - 15-30 mcg intralumbarally, and with each subsequent injection the dose is increased (50 mcg, 100 mcg, 150 mcg, 200 mcg). Intralumbar injections are given every 3 days, a total of 8-10 injections are required per course. During the period of remission in the absence of manifestations of funicular myelosis, 100 mcg twice a month is prescribed for maintenance therapy, in the presence of neurological symptoms - 200–400 mcg 2–4 times a month.

To eliminate cyanocobalamin deficiency, it is administered intramuscularly or intravenously: for treatment, 1 mg daily for 1–2 weeks, maintenance dose 1–2 mg from 1 time per week to 1 time per month; for prevention – 1 mg once a month. The duration of treatment is determined individually.

Children

Administered subcutaneously at a dose of 1 mcg/kg, the maximum daily dose is 100 mcg. For nutritional anemia and anemia in premature babies - 30 mcg per day subcutaneously for 15 days, for aplastic anemia - 100 mcg until clinical and hematological improvement occurs.

For degenerative conditions after illness, Down's disease and cerebral palsy - 15-30 mcg subcutaneously every other day.

Doses and mode of administration depend on the pathology and range from 30 mcg to 100 mcg per day. The 500 mcg/ml dosage form is not used in children under 3 years of age.

special instructions

Vitamin B12 deficiency should be confirmed diagnostically before prescribing the drug, as it may mask folic acid deficiency.

During the treatment period, it is necessary to monitor peripheral blood parameters: on the 5-8th day of treatment, the number of reticulocytes and Fe concentration are determined. The number of red blood cells, Hb and color index must be monitored for 1 month 1-2 times a week, and then 2-4 times a month.

Remission is achieved when the number of erythrocytes increases to 4-4.5 million/μl, when the normal size of erythrocytes is reached, aniso- and poikilocytosis disappears, and the number of reticulocytes normalizes after a reticulocyte crisis. After hematological remission is achieved, peripheral blood monitoring is carried out at least once every 4-6 months.

Use caution in persons prone to thrombus formation with angina pectoris (in lower doses, up to 0.1 mg per injection). Take for a long time for pernicious anemia, upcoming operations on the gastrointestinal tract.

When used in recommended doses in elderly people, no adverse reactions other than those listed above were observed.

Drug interactions

Pharmaceutically incompatible with ascorbic acid, heavy metal salts (inactivation of cyanocobalamin), thiamine bromide, pyridoxine, riboflavin (since the cobalt ion contained in the cyanocobalamin molecule destroys other vitamins).

Aminoglycosides, salicylates, antiepileptic drugs, colchicine, K+ drugs reduce absorption. Strengthens the development of allergic reactions caused by thiamine.

Chloramphenicol reduces the hematopoietic response.

Cannot be combined with drugs that increase blood clotting.

The risk of developing allergic reactions due to thiamine.

Contraindications

Hypersensitivity to the components of the drug, thromboembolism, erythremia, erythrocytosis, pregnancy (there are separate indications of the possible teratogenic effect of B vitamins in high doses), lactation period, children under 3 years of age for this dosage form. Leber's disease, nicotine amblyopia (increases the risk of neurodegenerative damage to the optic nerve).

Angina pectoris FC III, benign and malignant neoplasms (except for cases accompanied by megaloblastic anemia and vitamin B12 deficiency), tendency to form blood clots.

Vitamin B12 (cyanocobalamin) solution d/in 0.5 mg/ml amp 1 ml N10

Registration Certificate Holder

StatusPharm (Russia)

Dosage form

Medicine - Cyanocobalamin

Description

Solution for injection
1 ml
cyanocobalamin 500 mcg

1 ml - ampoules (10) - cardboard packs.

Indications

Anemia due to B12 deficiency conditions; as part of complex therapy for iron deficiency and posthemorrhagic anemia; aplastic anemia caused by toxic substances and drugs; liver diseases (hepatitis, cirrhosis); funicular myelosis; polyneuritis; radiculitis; neuralgia; amyotrophic lateral sclerosis; cerebral palsy; Down's disease; peripheral nerve injuries; skin diseases (psoriasis, photodermatoses, dermatitis herpetiformis, neurodermatitis); for the prevention and treatment of symptoms of vitamin B12 deficiency (including when using biguanides, PAS, vitamin C in high doses); radiation sickness.

Contraindications for use

Hypersensitivity to cyanocobalamin; thromboembolism, erythremia, erythrocytosis; pregnancy, breastfeeding period.

Carefully

Angina pectoris, benign and malignant neoplasms, accompanied by megaloblastic anemia and cyanocobalamin deficiency, a tendency to form blood clots.

pharmachologic effect

Vitamin B12 belongs to the group of water-soluble vitamins. Has high biological activity. Necessary for normal hematopoiesis (promotes the maturation of red blood cells). Participates in the processes of transmethylation, hydrogen transfer, formation of methionine, nucleic acids, choline, creatine. Promotes the accumulation of compounds containing sulfhydryl groups in erythrocytes. Has a beneficial effect on the function of the liver and nervous system. Participates in the synthesis of the myelin sheath, stimulates hematopoiesis, reduces pain associated with damage to the peripheral nervous system, stimulates nucleic metabolism through the activation of folic acid. Activates the blood coagulation system, in high doses causes an increase in the activity of thromboplastin and prothrombin.

Drug interactions

When used simultaneously with hormonal contraceptives for oral administration, a decrease in the concentration of cyanocobalamin in the blood plasma is possible.

When used simultaneously with anticonvulsants, the absorption of cyanocobalamin from the intestine decreases.

When administered parenterally, chloramphenicol may reduce the hematopoietic effect of cyanocobalamin in anemia.

The risk of developing allergic reactions increases when cyanocobalamin is used together with thiamine.

With simultaneous use, aminoglycosides, salicylates, antiepileptic drugs, colchicine, potassium preparations, cimetidine, metformin, oral contraceptives, ranitidine, triamterene, methotrexate reduce the absorption of cyanocobalamin from the intestine.

Cyanocobalamin is pharmaceutically incompatible with ascorbic acid, heavy metal salts, thiamine bromide, pyridoxine, riboflavin.

Dosage regimen

Used orally, subcutaneously, intramuscularly, intravenously and intralumbarally. The dosage regimen is set individually, depending on the indications, clinical situation, age of the patient and the dosage form used.

Side effect

Possible: allergic reactions, mental agitation, cardialgia, tachycardia, diarrhea, headache, dizziness; when used in high doses - hypercoagulation, disturbance of purine metabolism.

special instructions

During treatment with cyanocobalamin, peripheral blood patterns and coagulation parameters should be regularly monitored.

Cyanocobalamin deficiency should be confirmed diagnostically before its use, as it may mask folic acid deficiency.

Antimetabolites and most antibiotics can affect the results of the quantitative determination of cyanocobalamin using microbiological techniques.

Use during pregnancy and breastfeeding

Restrictions during pregnancy - Contraindicated. Restrictions when breastfeeding - Contraindicated. Contraindicated for use during pregnancy and breastfeeding.

Use in children

Restrictions for children - With caution. Can be used in children according to indications, in recommended doses and regimens. It is necessary to strictly follow the instructions in the instructions for the medical use of cyanocobalamin preparations in children.

Vitamin B12 (cobalamin, cyanocobalamin, Cobalamin) in the blood

Description

Vitamin B12 is a water-soluble vitamin. 5% of B12 entering the body is deposited in organs and tissues in the form of coenzyme. Vitamin B12 is found primarily in animal products and can accumulate in the body.

Biological action

Cyanocobalamin is necessary for the metabolism of fatty acids and helps increase oxygen consumption by cells during acute and chronic hypoxia. Vitamin B12 is involved in the processes of transmethylation, hydrogen transfer, and activates the synthesis of methionine. By promoting protein synthesis in the body, cyanocobalamin has an anabolic effect.

By increasing the phagocytic activity of leukocytes and activating the activity of the reticuloendothelial system, cyanocobalamin strengthens the immune system. Vitamin B12 plays an important role in regulating the function of hematopoietic organs: it takes part in the synthesis of purine and pyrimidine bases, nucleic acids necessary for the process of erythropoiesis, and actively influences the accumulation of compounds containing sulfhydryl groups in erythrocytes.

The supply of cyanocobalamin affects a wide range of emotional and cognitive abilities. Maintaining an optimal level of this vitamin helps prevent manifestations of dysfunction of the central nervous system and dementia.

Vitamin B12 “helps” adapt to changes in sleep and wakefulness, which is explained by the participation of cyanocobalamin in the synthesis of melatonin. Vitamin B12, along with other micronutrients, is essential for maintaining healthy reproductive systems in men and women.

Causes of vitamin B12 deficiency

: insufficiency in the diet of food of animal origin, calcium deficiency, enterocolitis, resection of the stomach or intestines, atrophic gastritis, helminthic diseases, liver diseases, taking some anti-tuberculosis and anti-diabetic drugs, some antibiotics (neomycin).

Vitamin B12 deficiency :

leads to the development of hematopoietic disorders,
damage to the nervous system,
atrophic changes in the epithelium of the gastrointestinal tract,
atherosclerosis, fatty hepatosis, methylmalonic aciduria.

Children with a genetic defect in the enzymes needed to convert vitamin B12 may develop megaloblastic anemia when blood levels of the vitamin are normal.

Preparation

Blood for research is taken strictly on an empty stomach; at least 8 hours must pass between the last meal and blood collection. Juice, tea, coffee, especially with sugar, are also food, this must be remembered. Drinking water does not affect blood counts.
1-2 days before the examination, it is advisable to exclude fatty, fried and alcohol from the diet. Refrain from smoking a couple of hours before taking blood.
One day before donating blood, it is advisable to avoid physical activity; you should also avoid physical stress (running, climbing stairs) and emotional excitement before donating blood. Before the procedure, you should rest for 10-15 minutes and calm down.
Blood should not be donated immediately after an x-ray, ultrasound, massage, reflexology or physiotherapeutic procedures.
If possible, avoid taking medications. Some types of studies (for example, dysbiosis) are done strictly before taking antibiotics and chemotherapy drugs. The exception is special studies of drug concentrations in the blood. If you have difficulty stopping your medications, be sure to tell your doctor.