Clinical medicine profile
Cyanocobalamin
Vitamin C [EPC], Vitamin D [EPC], Vitamin B6 Analog [EPC]
- Route
- ORAL / IM / IV (selected)
- Schedule
- POM
- ATC
- Not assigned
- PPB status
- registered
Safety essentials
The information most likely to change a prescribing or dispensing decision.
WARNING: Ingestion of more than 3 grams of omega-3 fatty acids (such as DHA) per day has been shown to have potential antithrombotic effects, including an increased bleeding time and International Normalized Ratio (INR). Administration of omega-3 fatty acids should be avoided in patients taking anticoagulants and in those known to have an inherited or acquired predisposition to bleeding. WARNING: Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6. Keep this product out of reach of children. In case of accidental overdose, call a doctor or poison control center immediately.
Contraindications
- Hypervitaminosis risk states (hypercalcaemia for vitamin D/A).
- Iron: avoid in iron overload.
- Potassium: severe hyperkalaemia / untreated Addison's.
Precautions
- Treat confirmed deficiency with monitored repletion.
- Avoid megadoses without indication.
- Iron: keep away from children (overdose lethal).
Dosing matrix
Population and organ-function guidance, shown together for faster comparison.
Depends on the degree of deficiency. Otherwise, 100 mcg daily for 6 or 7 days should be given by IM or deep SC then on alternate days for seven doses followed by every 3 to 4 days for another 2 to 3 weeks.
See label paediatric section if present; otherwise use paediatric formulary — do not extrapolate adult doses.
Fat-soluble vitamins and potassium need care in advanced CKD.
- CrCl 0–120: Confirm renal dosing in product SmPC / primary label.
Vitamin A toxicity hepatic; niacin hepatotoxicity at high dose.
Use, effects & interactions
Indications
INDICATIONS: PNV-DHA is a multivitamin/multimineral fatty acid dietary supplement indicated for use in improving the nutritional status of women throughout pregnancy and in the postnatal period for both lactating and nonlactating mothers.
Adverse effects
- GI upset (iron, high-dose vitamin C).
- Hypercalcaemia (vitamin D excess).
- Neuropathy with B6 megadoses.
- Flushing (niacin).
Drug interactions
Open multi-drug checker ↗- Cyanocobalamin and hydroxocobalamin are synthetic forms of Vitamin B12.
- Cyanocobalamin and hydroxocobalamin have similar indications but hydroxocobalamin may be preferred for treatment of B12 deficiency since optic neuropathies may degenerate with the administration of cyanocobalamin.
Mechanism & disposition
It acts as a coenzyme for various metabolic functions such as protein synthesis and fat and carbohydrate metabolism.
Read complete mechanism
It acts as a coenzyme for various metabolic functions such as protein synthesis and fat and carbohydrate metabolism. Vitamins and minerals act as cofactors, antioxidants, structural elements or hormone precursors (e.g. vitamin D endocrine axis). Pharmacological high-dose effects differ from nutritional repletion.
Days–weeks for repletion
Depends on stores and ongoing intake
ORAL / IM / IV (selected)
depends on GI integrity, food matrix and binders (e.g. calcium/iron interactions). Fat-soluble vitamins (A,D,E,K) accumulate; water-soluble generally renally cleared.
Pregnancy, lactation & diet
Folic acid preconception/first trimester critical. Iron/folate common in ANC. Avoid excess vitamin A.
Maternal repletion often appropriate; avoid megadoses.
Brands & loaded prices
| Brand | Manufacturer | Pack | Observed price |
|---|---|---|---|
| No reviewed brand listings are linked yet. | |||
Sources & review state
Decision support only. Confirm patient-specific decisions against the current product SmPC, Kenya STG/EML, and professional judgement.