AHFS Class:

88:08 Vitamin B Complex

Generic Name

• Cyanocobalamin

Cyanocobalamin is available as a 1-mg/mL solution for injection in 1-, 10-, or 30-mL multiple-dose vials.³⁹⁶⁰; ³⁹⁶¹ Each mL contains cyanocobalamin 1000 mcg and sodium chloride 0.9%³⁹⁶¹ or sodium chloride 0.4% and sodium acetate 0.04%³⁹⁶⁰ in water for injection with benzyl alcohol 1.5% as a preservative.³⁹⁶⁰; ³⁹⁶¹ Sodium hydroxide and/or hydrochloric acid³⁹⁶¹ or glacial acetic acid³⁹⁶⁰ may have been added during manufacturing to adjust pH.³⁹⁶⁰; ³⁹⁶¹ Aluminum also is present.³⁹⁶⁰; ³⁹⁶¹

pH

From 4.5 to 7.³⁹⁶⁰

Aluminum Content

Aluminum content may vary depending on the product; specific product labeling should be consulted.

Cyanocobalamin injection (Dodex, Accord) is stated to contain no more than 200 mcg of aluminum per L.³⁹⁶⁰

Cyanocobalamin injection (American Regent) is stated to contain no more than 625 mcg of aluminum per L.³⁹⁶¹

Trade Name(s)

Dodex

Cyanocobalamin is administered by intramuscular or deep subcutaneous injection.³⁹⁶⁰ The intravenous route is not recommended because the drug is excreted more rapidly and almost all of the cyanocobalamin is lost in the urine.³⁹⁶⁰

Cyanocobalamin injection should be stored at controlled room temperature and protected from light.³⁹⁶⁰; ³⁹⁶¹

The vitamins in Cernevit (Baxter) diluted in three 2-in-1 parenteral nutrition admixtures were tested for stability over 48 hours. Most of the vitamins, including cyanocobalamin, retained their initial concentrations.²⁷⁹⁶

pH Effects

Cyanocobalamin is stable at pH 3 to 7 but is most stable at pH 4.5 to 5.¹⁰⁷² It is stated to be incompatible with alkaline and strongly acidic solutions.⁴

Autoclaving

Cyanocobalamin is stated to be stable to autoclaving at 121°C for short periods.³⁹⁶⁰

Light Effects

Cyanocobalamin is unstable in light and should be protected from light.³⁹⁶⁰ Exposure to light results in the organometallic bond being cleaved, with the extent of degradation generally increasing with increasing light intensity.¹⁰⁷²

Sorption

Cyanocobalamin (Organon) 30 mg/L did not display significant sorption to a PVC plastic test strip in 24 hours.¹²

Filtration

Cyanocobalamin (Wyeth) 1 mg/L in dextrose 5% and in sodium chloride 0.9% was filtered at a rate of 120 mL/hr for 6 hours through a 0.22-µm cellulose ester membrane filter (Ivex-2). No significant reduction in potency due to binding to the filter was noted.⁵³³

Solution Compatibility

Additive Compatibility

Y-Site Injection Compatibility (1:1 Mixture)

For a list of references cited in the text of this monograph, search the monograph titled References.

ASHP^® Injectable Drug Information^TM. Selected Revisions September 12, 2024. © Copyright, 2024. American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.