Universal reference book for medicines
Product name: Cyanocobalamin-Bufus (CYANOCOBALAMIN-BUFUS)

Active substance: cyanocobalamin

Type: Vitamin B

Manufacturer: UPDATE (Russia)
Composition, form of production and packaging
Solution for injection
1 ml

cyanocobalamin 500 μg

1 ml - ampoules (10) - packs of cardboard.

1 ml - ampoules (100) - packs of cardboard.

INSTRUCTION FOR THE SPECIALIST.

Description of the drug approved by the manufacturer for the printed edition of 2015.

PHARMACHOLOGIC EFFECT

Vitamin B 12 .
In the body (mainly in the liver) is converted to methylcobalamin and 5-deoxyadenosylcobalamin. Methylcobalamin is involved in the reaction of homocysteine ​​to methionine and S-adenosylmethionine - the key reactions of the metabolism of pyrimidine and purine bases (and, consequently, DNA and RNA). If the vitamin is deficient in this reaction, it can be replaced by methyltetrahydrofolic acid, with folic acid reactions of metabolism being disturbed. 5-deoxyadenosylcobalamin serves as a cofactor in the isomerization of L-methylmalonyl-CoL in succinyl-CoA, an important carbohydrate and lipid metabolism reaction. Deficiency of vitamin B 12 leads to a violation of the proliferation of rapidly dividing cells of the hematopoietic tissue and epithelium, as well as to the violation of the formation of the myelin sheath of neurons.
PHARMACOKINETICS

In the blood, cyanocobalamin binds to transcobalamins I and II, which transport it to tissues.
It is deposited mainly in the liver. The connection with plasma proteins is 90%. C max after subcutaneous and / m administration is achieved after 1 h.
From the liver is excreted with bile into the intestine and again absorbed into the blood.
T 1/2 - 500 days. It is excreted at normal kidney function - 7-10% by kidneys, about 50% - by the intestine; with reduced renal function - 0-7% kidney, 70-100% - intestine. Penetrates through the placental barrier, into breast milk.
INDICATIONS

Conditions accompanied by a deficiency of vitamin B 12 :

- In 12- deficient anemia;

- in the complex therapy of anemia (including iron deficiency, posthemorrhagic, aplastic, anemia, caused by toxic substances and / or drugs).

In complex therapy in neurology:

- neuralgia (including trigeminal neuralgia), polyneuropathy (including alcoholic).

With the preventive purpose:

- with the appointment of biguanides, paraaminosalicylic acid, ascorbic acid in high doses, abnormalities of the stomach and intestines with a violation of absorption of vitamin B 12 (resection of part of the stomach, small intestine, Crohn's disease, celiac disease, malabsorption syndrome, sprue), radiation sickness.

DOSING MODE

Subcutaneously, in / in, / m.

Subcutaneously, with B12-deficiency anemia - 100-200 mcg / day every other day;
at В12-deficient anemia with addition of a violation of the function of the nervous system - 400-500 mcg / day in the first week - daily, then with intervals between administrations up to 5-7 days (concomitantly prescribe folic acid); during the remission, a maintenance dose of 100 mcg / day 2 times a month, with neurologic symptoms - 200-400 mcg 2-4 times a month.
In acute posthemorrhagic and iron deficiency anemia - 30-100 mcg 2-3 times a week;
at aplastic anemia, anemia caused by toxic substances and / or drugs - 100 μg before the onset of clinical and hematological improvement. With violations from the nervous system - 200-400 mcg 2-4 times a month.
In neurology: neuralgia (including trigeminal neuralgia), polyneuropathy (including alcoholic) - 200-500 mcg every other day for 2 weeks.

With a prophylactic goal - 60-100 mcg daily for 20-30 days.

To eliminate the deficiency of vitamin B 12 injected in / m or IV, 1 mg daily for 1-2 weeks.

Children of early age with alimentary anemia and premature infants - subcutaneously, 30 mcg daily for 15 days.

SIDE EFFECT

Allergic reactions, mental agitation, cardialgia, tachycardia, diarrhea, headache, dizziness, hypercoagulation, violation of purine metabolism.

CONTRAINDICATIONS

hypersensitivity;

- thromboembolism;

- Erythremia;

erythrocytosis;

- Pregnancy;

lactation period.

Carefully:

- angina pectoris;

- benign and malignant neoplasms, accompanied by megaloblastic anemia and vitamin B12 deficiency;

- propensity to form blood clots.

PREGNANCY AND LACTATION

The drug is not recommended for use during pregnancy and during breastfeeding, because
B vitamins in high doses have a teratogenic effect.
APPLICATION FOR CHILDREN

The application is possible according to the dosing regimen.

APPLICATION IN ELDERLY PATIENTS

The application is possible according to the dosing regimen.
When used in recommended doses, there were no adverse reactions in the elderly except for the above.
SPECIAL INSTRUCTIONS

Vitamin B deficiency should be confirmed diagnostically prior to prescribing, as it can mask the deficiency of folic acid.
During the period of treatment, it is necessary to monitor the parameters of peripheral blood: on the 5th-8th day of treatment, the content of reticulocytes, the concentration of iron is determined. The number of erythrocytes, hemoglobin and color index should be monitored for 1 month 1-2 times a week, and then - 2-4 times a month. Remission is achieved with an increase in the number of red blood cells to 4-4.5 million / μl, when normal erythrocyte sizes reach, aniso- and poikilocytosis disappear, normalizing the number of reticulocytes after a reticulocytic crisis. After reaching hematologic remission, peripheral blood monitoring is performed at least once every 4-6 months. Be careful in individuals prone to thrombosis, with angina (in smaller doses, up to 100 μg per injection).
When used in recommended doses, there were no adverse reactions in the elderly except for the above.

The ability to influence the speed of reactions when driving vehicles or working with other mechanisms

The adverse effect of the drug on the ability to drive vehicles and engage in other activities that require concentration and speed of psychomotor reactions were not reported.
However, given that the drug may cause dizziness, care should be taken when implementing these activities.
OVERDOSE

Data on overdose are absent.

DRUG INTERACTION

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

The risk of developing allergic reactions increases when combined with thiamine.

Aminoglycosides, salicylates, antiepileptic drugs, colchicine, potassium preparations reduce the absorption of cyanocobalamin.

Chloramphenicol reduces the hematopoietic response of cyanocobalamin.

Do not combine with drugs that increase blood coagulability.

TERMS OF RELEASE FROM PHARMACY

Letting go by prescription.

TERMS AND CONDITIONS OF STORAGE

In the dark place at a temperature of no higher than 15 ° C.
Keep out of the reach of children. Shelf life - 2 years.
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