Hydroxocobalamin
CYANOKIT
What it isHydroxylated vitamin B12 that binds cyanide as cyanocobalamin; cyanide poisoning and B12 deficiency.
Why this oneIt detoxifies cyanide without inducing methemoglobinemia, favoring it in smoke inhalation where nitrites can impair oxygen delivery.
What limits itDeep-red discoloration of skin, urine, and plasma interferes with colorimetric laboratory tests and some dialysis equipment.
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Vitamin B12 deficiency | adult | 30 mcg IM daily x5-10 days | 100-200 mcg IM monthly | |
| Vitamin B12 deficiency | pediatric | 100 mcg IM (total 1-5 mg over >=2 weeks) | 30-50 mcg IM q4wk (maintenance) | |
| Schilling test (flushing dose) | adult | 1000 mcg IM |
Renal Undefined
Hepatic Undefined
Instructions
- Administer intramuscularly only (oral not dependable)
- Protect from light; inspect for particulate matter/discoloration before use
- Monitor serum potassium closely first 48 h; supplement if needed
- Addisonian pernicious anemia requires lifelong parenteral therapy
Cautions
- Hypokalemia possible on correction of megaloblastic anemia - monitor potassium
- Hypersensitivity/anaphylaxis reported
Adverse reactions
- Mild transient diarrhea
- Itching, transitory exanthema
- Feeling of body swelling
- Anaphylaxis
- Injection-site pain
Pregnancy Category C; use only if clearly needed
Lactation Undefined
NO BOXED WARNINGS
Principal riskIt turns fluids red and blocks colorimetric assays
Classes and tags
Clinical profile
Mechanism of action: Hydroxocobalamin ballicule
