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Hydroxocobalamin is a form of vitamin B12 that is used to increase vitamin B12 levels. Common side effects include diarrhea, rash, itching, or pain from the injection. Serious side effects are rare and include allergic reactions. Hydroxocobalamin is given as an injection into the muscle (intramuscularly, or IM). Keep all appointments for lab work while you are using hydroxocobalamin.

Uses

What is hydroxocobalamin used for?

Hydroxocobalamin is a form of vitamin B12 commonly used for the following reasons.

Hydroxocobalamin may also be used for other conditions as determined by your health care provider.

Hydroxocobalamin is a form of vitamin B12. Another form of vitamin B12, called cyanocobalamin, is also available. See Cyanocobalamin for more information. 

How does hydroxocobalamin work (mechanism of action)?

Hydroxocobalamin is a form of vitamin B12, which is an essential nutrient. This means that your body does not make it, so you must get it from food. Your body uses vitamin B12 to keep nerve and blood cells healthy and to make DNA. 

In the United States, most people get enough vitamin B12 from food. It is found in animal products, such as meat, milk, and eggs. For most adults, the recommended daily intake of vitamin B12 is 2.4 micrograms (mcg). But some people either do not get enough from their diet or have trouble absorbing it. When this happens, your health care provider may prescribe hydroxocobalamin to replace what you are not getting from your diet.

How is hydroxocobalamin supplied (dosage forms)?

Brands and other names

  • Alpharedisol
  • Hydroxomin

Dosage forms and strengths

  • 30,000 mcg/30 mL (1,000 mcg/mL) multiple-dose vial

How should I store hydroxocobalamin?

Hydroxocobalamin should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place and protect from light.

Side Effects

What are the most common side effects of hydroxocobalamin?

The most common side effects of hydroxocobalamin are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Diarrhea
  • Rash or itching
  • Pain at the injection site

There may be other side effects of hydroxocobalamin that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of hydroxocobalamin?

While less common, the most serious side effects of hydroxocobalamin are described below, along with what to do if they happen.

Severe Allergic Reactions. Hydroxocobalamin may cause allergic reactions, which can be serious. Stop using hydroxocobalamin and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Warnings & Precautions

Who should not use hydroxocobalamin?

Allergies to Ingredients. People who are allergic to any of the following should not use hydroxocobalamin.

  • Alpharedisol
  • Cobalt
  • Hydroxocobalamin
  • Hydroxomin
  • Vitamin B12
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific hydroxocobalamin products they stock.

What should I know about hydroxocobalamin before using it?

Do not use hydroxocobalamin unless it has been prescribed to you by a health care provider. Use it as prescribed.

Do not share hydroxocobalamin with other people, even if they have the same condition as you. It may harm them.

Keep hydroxocobalamin out of the reach of children.

Hydroxocobalamin is given as an injection into the muscle (intramuscularly, or IM). It may be given by a health care provider in a health care facility. With proper training, it may also be given at home. If you will be using hydroxocobalmin at home, make sure that you or a caregiver understands how to properly prepare and inject hydroxocobalamin. 

Keep all of your appointments, including for lab tests. Lab tests are used to see how well hydroxocobalamin is working, monitor for side effects, and adjust your dose.

What should I tell my health care provider before using hydroxocobalamin?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if hydroxocobalamin is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have or have had any of the following.

Other Medicines and Supplements. Hydroxocobalamin may interact with other medicines and supplements. Before using hydroxocobalamin, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Tell your health care provider if you are pregnant or plan to become pregnant. Your health care provider will let you know if you should use hydroxocobalamin while you are pregnant or trying to get pregnant.

Breastfeeding. Hydroxocobalamin passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should use hydroxocobalamin while breastfeeding.

Interactions

Does hydroxocobalamin interact with foods or drinks?

There are no known interactions between hydroxocobalmin and foods or drinks.

It is unknown if drinking alcohol will affect hydroxocobalamin, but drinking large amounts of alcohol may lower the levels of vitamin B12 in your body. It is best to limit the amount of alcohol you drink.

Does hydroxocobalamin interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using hydroxocobalamin.

  • A proton pump inhibitor (PPI), such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), or rabeprazole (Aciphex)
  • An H2 blocker, such as cimetidine (Tagamet), famotidine (Pepcid, Zantac), or nizatidine (Axid)
  • Metformin (Fortamet, Glucophage, Glumetza), which is a medicine for diabetes
  • Colchicine, which is a medicine commonly used for gout

This may not be a complete list of medicines that can interact with hydroxocobalamin. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much hydroxocobalamin?

If you or someone else has used too much hydroxocobalamin, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of hydroxocobalamin?

If you get hydroxocobalamin injections in a health care facility and you miss an appointment, call to make another appointment as soon as possible. 

If you are using hydroxocobalamin at home and miss a dose, call your health care provider to find out when you should inject your next dose.