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Vitamin B12 Supplementation

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Vitamin B12 Supplementation, Cyanocobalamin Supplementation

  • Indications
  1. Vitamin B12 Deficiency (Pernicious Anemia)
  • Efficacy of oral dosing
  1. Oral B12 absorption via non-Intrinsic Factor pathway
  2. Large daily oral dose (1000 to 2000 mcg/day) is as effective as Parenteral (after 1 to 4 months)
  3. References
    1. Kuzminski (1998) Blood 92:1191-8 [PubMed]
    2. Wang (2018) Cochrane Database Syst Rev (3): CD004655 [PubMed]
    3. Sanz-Cuesta (2020) BMJ Open 10(8): e033687 [PubMed]
  1. Cyanocobalamin tablets
    1. Preparations: 25 mcg, 50 mcg, 100 mcg, 250 mcg tablet
    2. Initial: 2000 mcg PO daily for 2 weeks to 4 months
      1. Kuzminski (1998) Blood 92:1191-8 [PubMed]
    3. Maintenance: 1000 mcg PO daily
  2. Cyanocobalamin nasal gel 500 mcg each week
    1. Preparations: 400 ug/0.1 ml nasal gel
    2. Initial: 1500 mcg weekly intranasally for 3-4 weeks
    3. Maintenance: 500 mcg weekly
  3. Cyanocobalamin injection
    1. Initial: 1000 mcg IM daily for 2 weeks
    2. Maintenance: 1000 mcg IM every 1-3 months
  • References
  1. Little (1999) Am Fam Physician 59(6):1598-604 [PubMed]