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Vitamin B12 Supplementation

Aka: Vitamin B12 Supplementation, Cyanocobalamin Supplementation

Indications
1. Vitamin B12 Deficiency (Pernicious Anemia)
Efficacy of oral dosing
1. Oral B12 absorption via non-Intrinsic Factor pathway
2. Large daily oral dose is as effective as parenteral
3. References
  1. Kuzminski (1998) Blood 92:1191-8
Dosing: Vitamin B12 Deficiency
1. Cyanocobalamin tablets
  1. Preparations: 25 mcg, 50 mcg, 100 mcg, 250 mcg tablet
  2. Initial: 2000 mcg PO daily for 2 weeks to 4 months
    1. Kuzminski (1998) Blood 92:1191-8
  3. Maintenance: 1000 mcg PO daily
2. Cyanocobalamin nasal gel 500 mcg each week
  1. Preparations: 400 ug/0.1 ml nasal gel
  2. Initial: 1500 mcg weekly intranasally for 3-4 weeks
  3. Maintenance: 500 mcg weekly
3. Cyanocobalamin injection
  1. Initial: 1000 mcg IM daily for 2 weeks
  2. Maintenance: 1000 mcg IM every 1-3 months
References
1. Little (1999) Am Fam Physician 59(6):1598-604

Family Practice Notebook

Patients should address specific medical concerns with their physicians.

Although access to this page is not restricted, the information found here is intended for use by medical providers.

This page was written by Scott Moses, MD, last revised on 7/10/2009 and last published on 5/17/2012.

This is one of 5740 pages in the Family Practice Notebook