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hydroxocobalamin (injection)

Pronunciation: hye DROX o koe BAL a min

Brand: Cyanokit, Hydroxocobalamin

What is the most important information I should know about hydroxocobalamin?

If possible before you receive hydroxocobalamin, tell your caregivers if you have high blood pressure, heart disease, congestive heart failure, liver disease, or kidney disease (or if you are on dialysis).

Also tell your caregivers if you have ever had a severe allergic reaction to hydroxocobalamin, Vitamin B12, or cyanocobalamin (Nascobal, Cobolin, Cyomin, and others).

In an emergency situation it may not be possible before you are treated to tell your caregivers about your health conditions or if you are pregnant or breast feeding. Make sure any doctor caring for you afterward knows that you have received this medication.

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This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you have recently received a hydroxocobalamin injection.

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You may develop an acne-like skin rash within 1 to 4 weeks after you are treated with hydroxocobalamin. This rash should go away without treatment. Call your doctor if you have a rash that lasts longer than 4 weeks.

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If your skin turns red after receiving this medication, avoid exposure to sunlight or tanning beds. Hydroxocobalamin can make you sunburn more easily while your skin is still red. Wear protective clothing and use sunscreen (SPF 30 or higher) until your skin color returns to normal.

What is hydroxocobalamin?

Hydroxocobalamin is a form of vitamin B-12. It is used as an antidote to cyanide poisoning. Hydroxocobalamin works by helping cells in the body convert cyanide to a form that can be removed from the body through urination.

Hydroxocobalamin is used in an emergency to treat cyanide poisoning. This type of poisoning can occur if you are exposed to smoke from a house or industrial fire, if you swallow or breathe in cyanide, or if you get cyanide on your skin.

Hydroxocobalamin may also be used for purposes not listed in this medication guide.

What should I discuss with my health care provider before receiving hydroxocobalamin?

If possible before you receive hydroxocobalamin, tell your caregivers if you have:

  • high blood pressure;
  • heart disease;
  • congestive heart failure;
  • liver disease;
  • kidney disease (or if you are on dialysis); or
  • if you have ever had a severe allergic reaction to hydroxocobalamin, Vitamin B12, or cyanocobalamin (Nascobal, Cobolin, Cyomin, and others).
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FDA pregnancy category C. Tell your doctor if you are pregnant. It is not known whether hydroxocobalamin will harm an unborn baby. However, the benefits of treating cyanide poisoning may outweigh any risks posed by hydroxocobalamin, for both you and your baby.

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It is not known whether hydroxocobalamin passes into breast milk or if it could harm a nursing baby. You should not breast-feed after you have been treated with hydroxocobalamin.

In an emergency situation, it may not be possible before you are treated with hydroxocobalamin to tell your caregivers if you are pregnant or breast feeding. Make sure any doctor caring for your pregnancy or your baby knows you have received this medication.

How should I take hydroxocobalamin?

Hydroxocobalamin is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting. Hydroxocobalamin must be given slowly, and the IV infusion can take at least 15 minutes to complete.

Hydroxocobalamin is usually given only once. However, you may receive a second dose if needed.

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Your breathing, blood pressure, oxygen levels, heart function, and other vital signs will be watched closely while you are receiving hydroxocobalamin.

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This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you have recently received a hydroxocobalamin injection.

What happens if I miss a dose?

Since hydroxocobalamin is given by a healthcare professional in an emergency setting, you are not likely to miss a dose.

What happens if I overdose?

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid while taking hydroxocobalamin?

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If your skin turns red after receiving this medication, avoid exposure to sunlight or tanning beds. Hydroxocobalamin can make you sunburn more easily while your skin is still red. Wear protective clothing and use sunscreen (SPF 30 or higher) until your skin color returns to normal.

What are the possible side effects of hydroxocobalamin?

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Get emergency medical help if you have any of these signs of an allergic reaction: hives; chest tightness, difficulty breathing; swelling of your face, lips, tongue, or throat.

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You may develop an acne-like skin rash within 1 to 4 weeks after you are treated with hydroxocobalamin. This rash should go away without treatment. Call your doctor if you have a rash that lasts longer than 4 weeks.

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Call your doctor at once if you have a serious side effect such as:

  • bright red blood in your stools;
  • chest pain, fast or uneven heart rate;
  • severe shortness of breath, wheezing, gasping for breath, cough with foamy mucus;
  • swelling in your feet or ankles;
  • feeling like you might pass out; or
  • dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Less serious side effects may include:

  • red coloring of your urine (may last up to 5 weeks);
  • red coloring of your skin (may last up to 2 weeks);
  • eye redness or irritation;
  • acne, mild skin rash;
  • nausea, vomiting, diarrhea, stomach pain;
  • dry throat, trouble swallowing;
  • headache, dizziness, memory problems, restless feeling;
  • hot flashes; or
  • pain, swelling, or irritation of your skin where the injection was given.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect hydroxocobalamin?

There may be other drugs that can interact with hydroxocobalamin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

Your doctor or pharmacist can provide more information about hydroxocobalamin.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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