Hematology and Oncology Book

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Vitamin B12 SupplementationAka: Cyanocobalamin Supplementation

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  1. Indications
    1. Vitamin B12 Deficiency (Pernicious Anemia)
  2. 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
  3. 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
      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
  4. References
    1. Little (1999) Am Fam Physician 59(6):1598

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