Injections B12. Vitamin B12: Dosage and how to take

Homocystein

Homocysteine \u200b\u200bis a small molecule that is fermented into methionine by means of B12-dependent enzyme, and when the concentration B12 decreases below the optimal (therefore, the enzyme is not activated), the gomocysteine \u200b\u200bconcentration increases. The addition of B12 in the amount of 100-500mkg correlates with a decrease in homocysteine \u200b\u200bconcentration, while 10mkg does not have an effect, despite the fact that in many studies that used in-complex together with B12, dosages were used less than 10 μg.

Inflammation and immunology

Virology

It was found that the liver is a reservoir of B12 and many liver diseases are accompanied by a decrease in concentration of B12, which can elude from diagnostic control, because The concentration of B12 in the liver is not associated with a plasma concentration. Vitamin B12 also plays a role in the replication of the hepatitis C virus (inhibits the transmission on the inner surface of the ribosome without a concentration-dependent effect on the CAP-dependent mechanism) and it is assumed that it has the protective properties. In patients with hepatitis C, which received standard therapy (pegylated interferon A, with ribavmerin) or the same therapy, but with the addition of B12 (5000mkg intramuscularly every four weeks) for 48 weeks, the following effect was observed: a group that was obtained B12, Showed higher results early (21%) and a steady (34%) viral response. High doses of B12 can somehow provide a protective effect against hepatitis C in people who have already been infected, also B12 is able to reduce viral replication on the dose-dependent mechanism (only the hepatitis C virus is considered). In the same study, when considering the hepatitis C virus and the effect of inhibiting its replication, viruses of swine flu and encephalomyelitis were also considered, which B12 did not affect. It is likely that B12 is effective against hepatitis C virus, but not other viruses.

Vitamin B12 and pregnancy

Offspring

Nutrient interactions

Folate

Folic acid is most often used with B12, because High doses of folate can mask the manifestations of symptoms of anemia caused by a deficiency B12, which can only exacerbate the manifestations of macrocytic anemia, and not raise the risk of developing cognitive disorders associated with B12 deficiency. Based on the foregoing, the addition of B12 is used to reduce the risk of undiagnosed anemia during deficiency B12. The use of folic acid can mask manifestations of B12 deficient anemia, so they are most often accepted together, not because they work together, but only on the basis of reduce the risk of undiagnosed macrocytic anemia related to B12 deficiency. Adding B12 in the dosage to 500mkg does not affect the concentration of the folate in the plasma.

Safety and toxicology

General

High concentrations in serum B12 (hypercobalaminiamiamia, is considered from 950 to 709 pmol / l) states such as chronic myelogenic leukemia, proteomyo-leukemia, polycetemia and also hyperoeosinophilic syndrome, which is associated with an increase in the production of HAPTOORRINA (inactive conveyor). These diseases are very dangerous and require immediate diagnosis. There are side effects of some serious states that increase the concentration of B12 in plasma, but it is believed that B12 does not have any relation to this.

Products containing vitamin B12

Ultimately, animals should receive vitamin B12, directly or indirectly, from bacteria, and these bacteria can dwell in the intestinal section, which is most remote from that part, where B12 is absorbed. Thus, B12 should either come from bacteria to the BC12, or (in the presence of plant material in the intestine) as a result of feces recycling.
Vitamin B12 is contained in most food products of animal origin, including fish and molluscs, meat (especially liver), bird, eggs, milk and dairy products. However, the binding ability of egg yolk and protein decreases noticeably after heat treatment. The NGU (National Institute of Health) lists a number of animal food sources of vitamin B12.
Animals of vitamin B12:
Beef, offal and by-products, liver, boiled, fried: 83.1 μg vitamin B12 / 100 g
Turkey, all classes, lobs, cooked, boiled on slow fire, Fat Drops: 33.2
Braunschweig sausage pork liver: 20,1
Raw Pacific Oysters: 16.0
Cooked Kamchatka Crab: 11.5
Raw Mollusks: 11.3
Chicken loss prepared on slow heat: 9.4
Cheese: 3,3.
Beef (raw fillet): 1,15
Egg (raw eggs, whole chicken): 0.89
Whole cow's milk: 0.45
Raw Chicken Breasts: 0.20
In addition to certain fermented foods, only a few non-residential food sources of biologically active B12 were currently discovered, and none of them passed the tests on a person.
Some manufacturers of tea mushroom, such as GT Kombucha, as one of the ingredients of their product indicate Vitamin B12. One of these manufacturers even assures even that in one packaging of their product contains 20% of the daily rate of vitamin B12, which makes a tea mushroom with a potentially "high" food source B12. Since the tea mushroom is made as a result of symbiosis of yeast and bacteria, the possibility that it contains B12, does not contradict the available data. However, no scientific research has not yet been published confirming this fact, as well as the fact that B12 in tea mushroom is biologically active B12.
It has been established that Japanese fermented black tea, known as "Batabata Cha", contains biologically active B12. Unlike a tea mushroom, which is produced by fermentation of the ready-made tea, Batabata-cha is fermented by another leaf tea.
Chlorella, freshwater single-celled algae, was proposed as a source of vitamin B12, but this fact was not proven in animal analysis. Algae are believed to acquire B12 through symbiosis with heterotrophic bacteria, in which bacteria supplied B12 in exchange for fixed carbon. Spirulina and dried nori asakus (Porphyra Tenera) mainly contain pseudo-admins B12 instead of biologically active forms B12. While the nori asakus (Porphyra Tenera) contains mainly pseudo-namitamin B12, fresh algae, as reported, mainly contain biologically active forms B12, but even in a fresh form, vitamin activity has not been tested in enzyme analysis on animals.
One group of researchers reported that fresh red algae, known as Susabi-Nori (Porphyra Yezoensis), have the activity of B12 in the rat model, which implies that the source will also be active in the human body. These results were not confirmed.
The products enriched in B12 are also sources of vitamins, although they cannot be considered as true food sources of vitamin B12, since this vitamin is added in the form of a supplement from commercial sources of bacterial production, such as cyanocobalamin. Examples of products enriched with B12 include dry breakfasts, enriched soy products, enriched energy bars and vitamined food yeast. Society of Vegans of Great Britain, the Committee of Vegetarian Resources and the Committee of Doctors for Responsible Medicine, in particular, deny that vitamin B12 non-residential food sources are reliable and recommended to all vegans that do not receive food additives, eating foods enriched with vitamin B12. Not all of them may have the specified vitamin activity. Additives B12 added to the drinks, as reported in one study, contain different levels of pseudo-beam-B12. One of the reports it was reported that the analogues of B12 are present in various quantities in some multivitamins.
There are also non-traditional natural sources of vitamin B12, but their use as nutritional sources of vitamin B12 is very doubtful. For example, the remains of B12 from bacteria present in the soil may be contained on plants grown in the ground and not past the scrupulous cleaning procedure. B12 can also be found in lakes if the water has not passed the proper sanitary processing. In the body of some insects, such as termites, contains B12, which is produced by the bacteria of their intestines, in a sense, in a certain sense, like a ruminant animal. The intestine itself can contain bacteria producing B12 in the small intestine, but it is unclear whether a sufficient amount of this vitamin will be produced in this way to meet nutritional needs.

Vitamin B12 additives

Injecting hydroxycobalamin (1000 μg / ml) represents you a bright red liquid solution, which comes in 30 ml of multidosis brown glass bottles packed in paper boxes.
Vitamin B12 is supplied as a supplement for many food products, as well as available in the form of vitamin tablets, including polyvitamins. Healthy people can take vitamin B12 in the form of a liquid, transdermal plaster, nasal spray or injection, it is available separately or in combination with other additives. B12 is often found as the ingredient of energy drinks and power sector containing, as a rule, a few minimally recommended daily norms of vitamin B12. Vitamin B12 additives are effective for preventing its deficit, especially in vegetarians, and are often sold as an additive that promotes weight loss. However, there are no scientific studies that demonstrate the effectiveness of B12 in weight reduction.
Cyanocobalamin turns into its active shape, the first hydroxocobalamine, and then in methylcoobalamine and adenosylcobalamin in the liver.
The sublingual method of application, in which B12 is absorbed directly under the tongue, has not proven its need or utility, although a number of tablets, pill and even lollipops on the market are intended for sublingual applications. During the 2003 study, significant differences in serum blood levels were found during oral or sublingual use of 0.5 mg of cobalamin. Subject methods are effective only when taking high doses (0.5 mg). As noted below, such very high oral doses of B12 can be effective as treatment, even if the gastric atrophy (pernicious anemia) interferes in the absorption in the gastrointestinal tract).
Sometimes, if the digestive absorption is weakened, injections and plasters are used, but there is evidence that this method of use is not a need to have modern high-performance oral additives (for example, from 0.5 to 1 mg or more). Even pernicious anemia can be treated exclusively by orally. In these additives contain such large doses of vitamin, which from 1 to 5% of high oral doses of the free crystalline B12 is absorbed along the entire intestine by passive diffusion.
However, if the patient has congenital disorders in the MethylTransfer (Cobalamin Cobalaminium disease, in combination with methylmalon acidurium and homocystinuine), treatment with intravenous, intramuscular or transdermal use of hydroquococcalum B12 is necessary.

Morris MS, et al. Folate and Vitamin B-12 Status in Relation to Anemia, Macrocytosis, and Cognitive Impairment in Older Americans in the Age of Folic Acid Fortification. Am j Clin Nutr. (2007)

Most of the population of our country personally faced such unpleasant problems as the pathology of the joints, the lumbar department, neuritis, neuropathy and anemia. The characteristics of the climate, food behavior, lifestyle and the presence of chronic diseases inevitably lead to any of these pathologies.

It is these diseases that often lead to weakness, increased fatigue, a decrease in performance and memory, the appearance of the pallor of the skin and even pronounced pain syndrome. However, there is a safe decision of this issue.

The disappearance of actually diseases and their symptoms can cause a course of conventional vitamin therapy, namely intramuscular injections of vitamin B12.

Vitamin B12: Properties

According to the instructions for use, the pharmacological name of Vitamin B12 is Cyanocobalamin. This substance has high biological activity, which allows it to participate in all types of metabolism. Cianocobalamin has a set of positive effects on the body:

• It is a stimulator of the regeneration processes of almost all tissues of the human body.
• Beneficially affects metabolic processes in nerve fibers, restores the lost functions of neurons.
• Normalizes the activity of the hematopoietic system.
• Restores the function of the nervous system, as well as internal organs such as liver and spleen.
• Reduces cholesterol indicators in peripheral blood.

Despite the set of impact points, the main pharmacological actions of vitamin B12 are: counter-alememic, erythropoese stimulation (the process of formation of new erythrocytes), hematopois - synthesis of other blood cells, as well as the ability to restore nerve cells and elements of cartilage tissue.

Vitamin B12 absorption is carried out in the intestine. However, this process takes quite a long time (a few hours) and most of the vitamin is excreted from the body, without falling into systemic blood flow. It is due to this property that the cyanocobalamine is manufactured in ampoules, which contain a solution for intramuscular injections.

Indications

In the instructions for use, all diseases and conditions are prescribed to this drug, in which doctors recommend passing the course of therapy by this drug. These states include:

• Pathology of nervous tissue: neuralgia, radiculitis.
• Chronically leaking anemia with a deficit B12. These are such nosological diseases such as Addison-Burmer's disease, alimentary macrocytic anemia, etc.
• As an additional preparation for the treatment of iron deficiency anemia, aplastic and postgemorgic states.
• As a component of the complex treatment of hepatitis, cirrhosis of the liver, alcoholism, liver cellular insufficiency.
• It is also used in many congenital diseases: Daun's disease, cerebral paralysis, side amyotrophic sclerosis, funicular myelosa and other pathologies.
• Dermatological pathology of the skin: psoriasis and various types of dermatitis.
• Radiation sickness.
• Long-term migraine with trend towards progression.
• Malignant neoplasms of the gastrointestinal tract.
• Various diseases of the infectious profile.

In many cases, cyanocobalamin is not suitable for monotherapy, but is only one of the components of drug treatment. Despite this, clinicians often resort to the use of this substance to achieve a faster and qualitative result.

Contraindications

The solution of cyanocobalamin in ampoules is by its nature vitamin, the composition of which does not differ from the vitamin falling into the organism with food. The natural and safety of this medicinal substance cause a pretty poor list of contraindications. Namely:

• Hypersensitivity to the body to substance.
• Thrombosis, increased blood coagulation.
• Erythrocytosis (the content of erythrocytes is higher than the norm).

Also, the drug in ampoules is contraindicated pregnant women, since there is clinical data on its harmful effects on the fruit.

If the patient has a normal level of hemoglobin and red blood cells, then it is impractical to the appointment of the cyanocobalamine vitaminated therapy. And the independent purpose of any drugs may entail the deplorable consequences.

Side effect

It is non-compliance with contraindications, dosages and techniques of injection and lead to similar phenomena. In order to avoid them, follow the doctor's instructions.

Mode of application

Injections of cyanocobalamina can be carried out under the skin, in the muscle, in Vienna, as well as intralyumbal, that is, inside the spinal canal. However, most often the course of injections are stamped intramuscularly.

The drug dosage ranges from 15 to 500 or even 1000 μg per day. It depends on the state of the patient and its disease. The duration of the course also varies and is selected by the doctor individually. On average, the course of vitaminotherapy is 10-15 days.

As a rule, 1 injection per day is prescribed. One ampoule contains 1 ml of the drug in which 500 or 200 μg of vitamin is located.

It must be remembered that in one syringe it is impossible to mix vitamins B12, B6 and B1, because they are not compatible in its composition in its composition.

From the foregoing it follows that the drug is safe and very useful for the body. Use a solution of B12 in ampoules is more expedient, but if only oral administration is possible, it is carried out in combination with folic acid to improve the absorption process in the intestine.

During therapy, the cyanocobalamin should be followed by dynamics in the picture of peripheral blood. When achieving targets of red blood cells and hemoglobin is canceled.

The use of vitamin B12 in the composition of complex therapy of diseases of the joints, nervous or connective tissue not only leads to an increase in the pharmacological effect of the main drugs, but also prevents the progression of pathology.

Registration number: LS-000095-260110

Trade name of the drug: Cyanocobalamin

International UnPatented Name (MNN): Cyanocobalamin

Chemical name: alpha- (5,6-dimethylbenzimidazolyl) Cobamide

Dosage form: injection

Description: Transparent liquid from weakly pink to bright red.

Structure:
Per 1 ml:
Active substance: 1 ml is contained
Cyanocobalamina -200 or 500 μg
Excipients: water for injection, sodium chloride.

Pharmacotherapeutic group: Vitamin
ATX code B03BA01.

Pharmacological properties
Pharmacodynamics
Vitamin B 12 has a metabolic and hematopoietic effect. In the body (mainly in the liver) turns into a coenzyme form - adenosylcobalamin, or kobamimide, which is the active form of vitamin B 12 and is part of numerous enzymes, incl. The amount of reductase restoring folic acid into tetrahydrofoli. It has high biological activity.
Kobamamide is involved in the transfer of metal et al. Single-carbon fragments, therefore it is necessary for the formation of deoxyribose and DNA, creatine, methionine - donor of metallic groups, in the synthesis of lipotropic factor - choline, for the conversion of methylmalone acid and amber, part of myelin, to dispose of propionic Acids. We are necessary for normal blood formation - promotes the ripening of red blood cells.
It contributes to the accumulation of compounds containing sulfhydryl groups in red blood cells, which increases their hemolysis tolerance. Activates the rolling system of blood, in high doses it causes an increase in the thromboplastic activity and the activity of Promcrin. Reduces blood cholesterol. It has a beneficial effect on the function of the liver and nervous system. Increases tissue's ability to regenerate.
Daily need for vitamin B 12: for adult men - 1-2 mg; For elderly people -1.2-1.4 mg; For women - 1-2 mg (in pregnant women more by 0.5 mg, in nursing - by 0.6 mg); For children, depending on age - 0.3-1.4 mg.

Pharmacokinetics
In the blood, vitamin B 12 is associated with transcribed I and II transparency in tissue. Deposited mainly in the liver.
Communication with plasma proteins - 90%. The maximum concentration after subcutaneous and intramuscular administration - after 1 h.
From the liver is removed with bile in the intestines and is again absorbed into the blood. Half-life - 500 days. It is displayed at normal kidney function - 7-10% by kidneys, about 50% - with carte masses; With a reduced kidney function - 0-7% by kidneys, 70- 100% - with wheel masses. Penetrates the placental barrier, breast milk.

Indications for use
States accompanied by vitamin C 12:
Chronic anemia that flows with vitamin B 12 deficiency (Addison-Burmer's disease, alimentary macrocytic anemia), as part of the complex therapy of anemia (including iron deficiency, postgemorrhagic, aplastic, anemia caused by toxic substances and / or JIC).
In complex therapy:
Chronic hepatitis, liver cirrhosis, liver failure, alcoholism.
In neurology: polyneurite, radiculitis, hypotrophy, neuralgia (incl. neuralgia of a trigeminal nerve), the funicular myelosis, the disease peripheral nervously:; Traumatic Genesis Systems, Side Amiotrophic Sclerosis, Child Cerebral Paralysis, Down Disease.
In dermatology: Psoriasis, photo dermatosis, herpetyiform dermatitis, atopic dermatitis.
With a prophylactic goal - When appointing biguanids, PASK, ascorbic acid in high doses, stomach and intestine pathology with vitamin intake impaired in 12 (resection of parts of the stomach, small intestine, Crohn disease, Malabsorption Syndrome, Spring), enteritis, diarrhea, radiation disease.

Contraindications
Hypersensitivity to the components of the drug, thromboembolism, eritremia, erythrocytosis, pregnancy (there are separate indications of a possible teratogenic action of group vitamins in high doses), lactation period.

Carefully
Stenzardia, benign and malignant neoplasms, accompanied by megaloblastic anemia and vitamin C 12 deficiency, a tendency to the formation of thromboms.

Method of application and dose
The drug is applied subcutaneously, intramuscularly, intravenously and intrabulum.
Subcutaneously, with the anemia of Addison-Burmer - 100-200 μg / day after day; under the funicular myelose, macrocytic anemia with impaired function of the nervous system - 400-500 μg / day in the first week - daily, then at intervals between the introductions up to 5-7 days (simultaneously prescribed folic acid); During the remission, supporting dose -100 μg / day 2 times per month, and with violations of the function of the nervous system of 200-400 μg 2-4 times per month.
With acute postgemorgic and iron deficiency anemia - 30-100 μg 2-3 times a week; In aplastic anemia - 100 μg to the onset of clinical and hematological improvement. With violations from the nervous system - 200-400 μg 2-4 times a month.
In case of diseases of the central nervous system and the peripheral nervous system - 200-500 μg every other day for 2 weeks.
In case of diseases of the peripheral nervous system of traumatic genesis - 200-400 μg every other day within 40-45 days.
With hepatitis and liver cirrhosis - 30-60 μg / day or 100 μg every other day for 25-40 days.
With radiation sickness - 60-100 μg daily for 20-30 days. With funicular myelose, lateral amyotrophic sclerosis - intrablum, 15-30 μg with a gradual increase in dose to 200-250 μg per injection.
To eliminate the deficiency of vitamin B 12 is introduced in / m or in / in, 1 mg daily for 1-2 weeks.
Children of early age with alimentary anemia and premature children - subcutaneously 30 μg per day daily within 15 days. In dystrophy in children of early age, Daun's disease and children's cerebral paralysis - subcutaneously, 15-30 μg every other day.

Side effect
Allergic reactions, mental excitement, cardialia, tachycardia, diarrhea, headache, dizziness. When used in high doses - hypercoagulation, a violation of purine metabolism.

Interaction with other medicines
Pharmaceutically incompatible with ascorbic acid, salts of heavy metals (inactivation of cyanocobalamina), thiamine bromide, pyridoxine, riboflavin (because Cobalt ion contained in the cyanocobalamin molecule destroys other vitamins). It is impossible to combine with preparations that increase blood clotting. Aminoglycosides, salicylates, antiepileptic drugs, colchicine, potassium preparations reduce absorption.
Strengthens the risk of allergic reactions caused by thiamine.
Chloramphenicol reduces hemopoietic response.
Enhances toxic effect in combination with folic acid.

Special indication
Vitamin C 12 deficiency must be confirmed diagnorated before the drug is prescribed because it may mask a lack of folic acid. During the period of treatment, it is necessary to control the performance of peripheral blood: on 5-8 days of treatment, the content of reticulocytes, iron concentration is determined. The number of erythrocytes, HB and color indicator must be monitored for 1 month 1-2 times a week, and then 2-4 times a month. Remissance is achieved with increasing the number of erythrocytes to 4-4.5 million / μl, when the normal dimensions of the erythrocytes are reached, the disappearance of aniso- and causticity, the normalization of the content of reticulocytes after the reticulocyte crisis. After achieving hematological remission, peripheral blood control is carried out at least 1 time in 4-6 months.
Observe caution in persons prone to thrombosis, angina (in smaller doses up to 0.1 mg per injection). Take a long time with pernicious anemia, upcoming OCC operations. When adopting recommended doses during pregnancy, breastfeeding, as well as in the elderly, there were no side reactions in addition to the above-mentioned reactions.

Form release
1 ml in ampoules. 10 ampoules in a pack of cardboard with a knife for opening ampoules or scarifier ampumen.

Shelf life
2 years.
Do not use after the expiration date indicated on the package.

Storage conditions
In the place protected from light, inaccessible for children.
At a temperature not higher than 25 ° C.

Conditions of vacation from pharmacies
On prescription.

Manufacturer's enterprise
JSC "Yerevan Chemical Pharmaceutical Firm"
Russia 375040, Armenia, Yerevan, ul. Adjaryan 2nd Alley, number 6.

Claims receiving address:
LLC "Statoparm"
Russia 109316, Moscow, Ostapovsky Pr-d, D.5, p.1

Microorganisms responsible for the intestinal microflora are able to independently synthesize vitamin B12.

However, this is not enough, and the person needs to additionally receive this vitamin from the products or vitamin complexes.

Vitamin B12 in products is contained in small doses, so b12 will help to fill its reserves in the body in ampoules. Its price in pharmacies does not exceed 30-40 rubles for 10 pieces, and it is possible to buy it everywhere. Vitamin is introduced intramuscularly, intravenously and subcutaneously.

Here you will find instructions for use, readings, contraindications, side effects and symptoms of overdose.

We need everyone, but there are special categories of people with whom it is necessary more than others.

Vitamin B12 in ampoules need smokers, vegetarians, elderly people and people prone to depression

Alcohol and smokers. The body, weakened by tobacco smoke and alcohol, needs an increased amount of vitamins, including B12.

Vegetarians. Since B12 is contained mainly in animal products (meat, dairy products, fish), vegetarians are not allowed.

Elderly people. In order to prevent the development of senile dementia and deterioration in memory, it is important to maintain B12 balance at the desired level.

People inclined to depression. This vitamin contributes to improved mood, normalizes sleep and struggles with stress.

prescribed for the following diseases:

• anemia (pernicious, agastric, alimentary, toxic-dosage);
• malignant anemia;
• cirrhosis, hepatitis, Botkin's disease and other liver diseases;
• multiple sclerosis;
• migraine;
• radiation sickness;
• radiculitis;
• psoriasis.

Also B12 are prescribed to children with:

• cerebral paralysis;
• dauna diseases;
• aplastic anemia;
• distrophy.

What b12 in ampoules is better than in capsules?

In fact, the drug in capsules is no worse than ampoules. But the capsules can not always be used, for example, for the treatment of young children - it is introduced subcutaneously in the form of injections.

Dosage

Vitamin B12 in ampoules is prescribed in such doses:

1. Hepatitis, liver cirrhosis: within 25-40 days at 0.03-0.06 mg every day or 0.1 g a day.
2. In case of CNS diseases: within 14 days, 0.1-0.5 mg every day.
3. Radiation disease: within 25-30 days at 0.06-0.1 mg every day.
4. Premature children: within 15 days of 0.03 mg every day.
5. Dauna and cereal disease: within 15 days at 0.015-0.03 mg every day.
6. The recommended dose for adults with a disadvantage of vitamin in the body is 3 μg.

Attention! Only a doctor can be appointed accurate dose of vitamin.

Symptoms of overdose and contraindications

In case of overdose, vitamins may have pain in the heart, an allergic reaction and other disorders

B12 is contraindicated in pregnancy, lactation, thrombosis, eritremia, erythrocytosis, as well as with hypersensitivity to this vitamin.

Symptoms of overdose:

• allergic reactions;
• pain in the heart and rapid heartbeat;
• target disorder;
• nervous excitement, anxiety;
• hypercoagulation.

Side effects are usually manifested if the daily dose is exceeded several times. When these symptoms appear, it is necessary to temporarily stop the introduction of B12 and inform the doctor.

Unconventional use methods

Among women, the use of vitamins as cosmetics for body and hair care, and B12 is not an exception.

Mask for the face.Vitamin is applied to the face in combination with sour cream, oils, honey, other vitamins and extracts.

The B12 applied to the face has a smoothing and rejuvenating effect, narrows the pores, contributes to updating the epidermis, gives the skin a healthy look.

Vitamin B12 is used in hair masks and face masks

Vitamin mixtures for.It is believed that Vitamin B12 has a beneficial effect on the hair structure, strengthens them and speeds up growth.

Apply it by applying heads to the skin together with pharmaceutical oils or add the contents of the ampule directly into the shampoo bottle. Frequently used in conjunction with vitamins B1 and B6.

Vitamin B12 is one of the most important vitamins necessary for the health and full functioning of the body. Take this drug subcutaneously, intravenously or intramuscularly without appointing a doctor.

Before use, you need to pass tests and find out whether there is a lack of vitamin in order not to harm its body. If the doctor still appointed it, it is important to comply with all the recommendations and follow the instructions for use.

Cyanocobalamin (Vitamin B12)

International non-proprietary title

Cyanocobalamin

Dosage form

Injection solution 0.02% and 0.05%, 1 ml

Structure

1 ml of solution contains

active substance -cyanocobalamin (in terms of 100% substance) 0.20 mg, 0.50 mg

excipients:sodium chloride, 0.1 m hydrochloric acid, water for injection.

Description

Transparent liquid from weakly pink to bright red

Pharmacotherapeutic group

Hematopois stimulants. Vitamin B12 and folic acid. Cyanocobalamin and its derivatives. Cyanocobalamin

ATH Code B03V01

Pharmacological properties

Pharmacokinetics

Suction takes place all over the delicate intestine, a slight amount is absorbed in the thick intestine. The ileum connects with a special internal factor, which is produced by cells of the foundal part of the stomach and becomes inaccessible for intestinal microorganisms. The complex in the wall of the small intestine transmits the cyanocobalamin to the receptor, which transports it into the cage. In the blood, vitamin B12 is associated with transcalaminamins 1 and 2, which transport it to the tissue. Deposited mainly in the liver. Communication with blood plasma proteins - 90%. The maximum concentration in the blood plasma after subcutaneous and intramuscular administration is achieved after 1 hour. From the liver is excreted bile in the intestines and is again absorbed into the blood. Half-life in the liver - 500 days. It is displayed at a normal kidney function - 7 - 10% by kidneys, about 50% - with carte masses, and with a reduced kidney function - 0 - 7% by kidneys, 70 - 100% with wheel masses. Penetrates the placental barrier, in breast milk.

Pharmacodynamics

Cyanocobalamin has a metabolic, hematopoietic effect. In the body (mainly in the liver) turns into a coenzyme form - adenosylcobalamin, or kobamamide, which is the active form of cyanocobalamin and is part of numerous enzymes, incl. The amount of reductase restoring folic acid into tetrahydrofoli. It has high biological activity.

Kobamimide is involved in the transfer of methyl and other single-carbon fragments, therefore it is necessary for the formation of deoxyribose and DNA, creatine, methionine - donor of methyl groups, in the synthesis of lipotropic factor - choline, for the conversion of methylmalone acid into amber, part of myelin, to dispose of propionic acid . We are necessary for normal blood formation - promotes the ripening of red blood cells.

It contributes to the accumulation of compounds containing sulfhydryl groups in red blood cells, which increases their hemolysis tolerance. Activates the rolling system of blood, in high doses it causes an increase in the thromboplastic activity and the activity of Promcrin. Reduces cholesterol concentration in the blood. It has a beneficial effect on the function of the liver and nervous system. Increases tissue's ability to regenerate.

Indications for use

Gipo and vitamin B12 Avitamint (Addison-Burmer's disease, Alimentary macrocytic anemia)

Comprehensive therapy

- Conductible, postgemorgic, aplastic anemia and anemia caused by toxic substances and / or drugs

Chronic hepatitis, liver cirrhosis, liver failure

Alcoholism

Long fever

Polyneurite, radiculitis, neuralgia (including neuralgia of triple nerve), traumatic damage to nerves, diabetic neuritis, cuelaery myelosis, lateral amyotrophic sclerosis, children's cerebral palsy, Dauna disease

Skin diseases (psoriasis, photodermatosis, herpetyiform dermatitis, atopic dermatitis)

FROM Preventive goal for

- The appointment of biguanides, para-amalicy acid, ascorbic acid in high doses

Pathology of the stomach and intestines with impaired of the absorption of cyanocobalamin (resection of part of the stomach, small intestine, Crohn's disease, celiac disease, Malabsorption syndrome, SPRU)

Malignant Pancreas and Intestinal Education

Radiation sickness

Method of application and dose

Enter intramuscularly, subcutaneously, intravenously and intrabulum.

Subcutaneously, as anemiaassociated with a vitamin B12 deficiency, administered at 0.1 - 0.2 mg 1 time in 2 days, with addison Burmer anemia With the phenomena of the funicular myelosa and the macrocytic anemia with the lesions of the nervous system - 0.5 mg and more for injection in the first week daily, and then at intervals up to 5 to 7 days. Simultaneously prescribe folic acid.

For postghemorgic and iron deficiency anemia prescribe 0.03-0.1 mg 2 - 3 times a week, with aplastic anemia In childhood and prematurely - 0.03mg a day for 15 days.

For diseases of the central nervous system (lateral amyotrophic sclerosis, encephalomyelitis, etc.) and neurological diseases with pain syndrome are injected into increasing doses from 0.2 to 0.5 mg per injection, and when the state is improved - 0.1 mg per day, a course of treatment up to 2 weeks . At traumatic lesions of peripheral nerves, 0.2 - 0.4 mg are prescribed 1 time in 2 days within 40-45 days.

For hepatitis and liver cirrhots Enter (adults and children) at 0.03-0.06 mg per day or 0.1 mg every other day for 25-40 days.

For sPRU, radiation disease, diabetic neuropathy And other diseases are usually prescribed by 0.06-0.1 mg daily for 20-30 days.

For treatment funicular Melza, amiotrophic side sclerosis, sclerosisit is sometimes introduced into the spinal channel 0.015-0.03 mg, gradually increasing the dose to 0.2-0.25 mg.

Children of early age with alimentary anemia and premature children are injected subcutaneously 30 μg per day for 15 days. For dystrophy in young children, dauna disease and children's cerebral paralysissubcutaneously 15-30 μg every other day.

Side effects

Allergic reactions, itching, skin rashes

Mental arousal, headache, dizziness

Cardialiag, Tachycardia

Hypercoagulation, violation of purine metabolism when applying high doses

Contraindications

Hypersensitivity to the components of the drug

Thromboembolia

Eritremia, Erythrocytosis

Pregnancy and lactation period

Medicinal interactions

It is not recommended to introduce together (in one syringe) vitamins B12, B1, B6, since the cobalt ion contained in the molecule contributes to the destruction of other vitamins. It is also necessary to take into account that vitamin B12 can enhance allergic reactions caused by vitamin B1.

Pharmaceutically incompatible with ascorbic acid, heavy metals salts (inactivation of cyanocobalamin), thiamine bromide, pyridoxine, riboflavin.

Aminoglycosides, salicylates, antiepileptic drugs, colchistes, potassium preparations reduce the absorption of cyanocobalamin. Chloramphenicol reduces hemopoietic response. Cyanocobalamin can not be combined with blood clotting preparations.

special instructions

The shortage of cyanocobalamin must be confirmed diagnorated before the drug is prescribed because it can mask the lack of folic acid.

It is impossible to introduce vitamin B12 with sharp thromboembolic diseases. Above caution in individuals prone to thrombosis, with angina (in smaller doses, up to 100 μg per injection). It is necessary to control blood clotting.

During the period of treatment, it is necessary to control the performance of peripheral blood: on the 5-8 day of treatment, the number of reticulocytes is determined. The number of erythrocytes, hemoglobin and color indicator must be monitored within 1 month 1-2 times a week, and then 2-4 times a month. In the case of the development of leuco- and red blood cells, the dose of the drug must be reduced or temporarily interrupted the treatment, respecting caution when a leaning towards thrombosis. Remissation is achieved with increasing the number of erythrocytes to 4-4.5 million / μl, when the normal dimensions of the erythrocytes are reached, the disappearance of aniso- and causticity, the normalization of the number of reticulocytes after the reticulocyte crisis. After achieving hematological remission, peripheral blood control is carried out at least 1 time in 4 - 6 months. There are separate instructions on the possible teratogenic action of the group vitamins in high doses.

Features of the influence of the medicinal product on the ability to control the vehicle or potentially hazardous mechanisms

Considering the side effects of the drug, caution should be taken when managing transport and work requiring concentration.

Overdose

Symptoms -strengthening the side effects of the drug

Treatment - symptomatic.

Release form and packaging

1 ml into a neutral glass ampoules for syringe filling or imported, or sterile sterile ampoules for syringe filling imported, with a break point or a ring of a break.

The label or script paper label is glued to each ampoule.

5 or 10 ampoules are packaged into the contour cellular packaging from the film of polyvinyl chloride and aluminum foil, or imported.

Contour cell packaging together with approved medical application instructions in public and Russian are placed in carton boxes or corrugated cardboard.

In group packaging in the number of packages, approved medical instructions in the state and Russian languages \u200b\u200bare investing.

Storage conditions

Store in a dry, protected from light, at a temperature not higher than 30 ° C.

Keep out of the reach of children!

Storage term

Do not use after the expiration date.

Conditions of vacation from pharmacies

On prescription

Name and country of the manufacturer

JSC "Himfarm", Republic of Kazakhstan,

g. Shymkent, ul. Rashidova, 81.

Name and country of the owner of the registration certificate

JSC "Himfarm", Republic of Kazakhstan

The address of the organization hosting on the territory of the Republic of Kazakhstan complaints from consumers for product quality (product)

JSC "Himfarm", Shymkent, Republic of Kazakhstan, 160019

ul. Rashidova, 81.

Telephone number 7252 (561342)

Fax number 7252 (561342)

E-mail address [Email Protected]