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Hydroxocobalamin (injection)

Generic name: hydroxocobalamin (injection) [hye-DROX-o-koe-BAL-a-min]

Brand names: Cyanokit, Hydroxy-Cobal, Hydro-Cobex, Cobalin-H, Neo-Cytamen
Dosage forms: injectable solution (1 mg/mL) and intravenous powder (5 g).

Drug class: vitamins

What is Hydroxocobalamin?

Hydroxocobalamin, also known as vitamin B-12, is one form. It is used to treat cyanide intoxication. Hydroxocobalamin helps cells in the body convert cyanide into a form that can be excreted from the body by urination.In an emergency, hydroxocobalamin can be used to treat cyanide. You can get this type of poisoning if smoke from an industrial or house fire is inhaled, you swallow cyanide, or you touch cyanide on your skin.This medication guide does not list all possible uses of hydroxocobalamin.

Side effects of Hydroxocobalamin

If you experience any of the following symptoms of an allergic reaction, seek emergency medical attention: hives, chest tightness, difficulty breathing, swelling of your lips, face, tongue, or throat.After hydroxocobalamin treatment, you may develop a skin rash that looks like acne. This rash will go away on its own. If your rash lasts more than four weeks, call your doctor.

If you experience a serious adverse reaction, such as:

  • Bright red blood in the stool;
  • Chest pain caused by a fast or irregular heartbeat
  • Cough, foamy mucus, severe shortness of breath;
  • Swelling of the feet or ankles
  • A feeling of lightheadedness, as if you could pass out.
  • High blood pressure can be dangerous (headache, anxiety, blurred vision or buzzing in the ears, chest pains, irregular heartbeats, seizures, confusion).

Some of the common side effects associated with hydroxocobalamin include:

  • Nausea;
  • Headache;
  • Acne, skin rash, and redness
  • Red coloration of urine (may last from 2 to 5 weeks);
  • Pain, swelling, or irritation at the site of injection.

There may be other side effects. For medical advice on side effects, call your doctor. Contact the FDA by dialing 1-800-FDA-1088 in order to report adverse side effects.

Similar/related drugs

cyanocobalamin, vitamin B12, hydroxocobalamin, amyl nitrite, dodex, neuroforte-R, and sodium thiosulfate


It may not always be possible to inform your caregivers of your medical conditions in an emergency. Be sure that any doctor who treats you in the future knows that you received hydroxocobalamin.

Before you take this drug

Tell your caregivers, if possible, before receiving hydroxocobalamin if you:

  • High blood pressure
  • Heart disease
  • Congestive heart failure;
  • Liver disease
  • If you have kidney disease or are currently on dialysis,
  • If you've ever experienced a severe reaction to hydroxocobalamin (Vitamin B12), cyanocobalamin, or nascobal (Cobolin, Cyomin, and others),

FDA pregnancy category C Tell your doctor if you are pregnant. Hydroxocobalamin is not known to harm a baby. Hydroxocobalamin may be less harmful than cyanide to your unborn baby, but the benefits of treating it could outweigh its risks.Hydroxocobalamin is not known to pass into breast milk or to harm a baby who is nursing. After taking hydroxocobalamin, you should not breastfeed.It may not be possible to inform your caregivers that you are breastfeeding or pregnant in an emergency before receiving hydroxocobalamin. Be sure to tell any doctor who is caring for you or your child that you've received this medication.

How to take Hydroxocobalamin?

The hydroxocobalamin injection is administered through an intravenous line. This injection will be given in a hospital or clinic setting. The IV infusion of hydroxocobalamin can take up to 15 minutes.Hydroxocobalamin will usually only be given once. You may need a second dose.While you receive hydroxocobalamin, your breathing, blood oxygen levels, heart functions, and other vital indicators will be closely monitored.This medication may cause abnormal results in certain medical tests. Tell your doctor that you recently received an injection of hydroxocobalamin.

What happens if I miss the dose?

You are unlikely to miss a dose of hydroxocobalamin since it is administered by a medical professional in an urgent situation.

What happens if I overdose?

Overdoses are unlikely because this medication is administered by a health professional in a medical environment.

What should be avoided?

Avoid tanning or exposure to the sun if your skin becomes red after taking this medication. While your skin is red, hydroxocobalamin may make you burn easier. Use sunscreen with an SPF of 30 or greater until the skin color returns.

Interaction with other drug

Hydroxocobalamin may also interact with other drugs, such as vitamins and herbal remedies. Inform your healthcare providers of all the medicines you are taking and those you plan to take.