Cyanocobalamin (B12)

(Commercial Product) Injection

1,000 mcg/mL

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Product Overview

Cyanocobalamin (B12) Description1

Cyanocobalamin is a synthetic form of vitamin B12 that supports multiple methylation reactions in the body. It is required for growth, cell replication, hematopoiesis, and the synthesis of nucleoproteins and myelin. Tissues with rapid cellular turnover, such as epithelial tissue, bone marrow, and myeloid cells, have the highest demand for cyanocobalamin.

Cyanocobalamin has numerous approved indications, many of which involve conditions that result in cyanocobalamin deficiency due to impaired absorption, including:

  • Pernicious anemia
  • Malabsorption
  • Atrophic gastritis
  • Long-term metformin use
  • Chronic acid-reducing medication use
  • Small bowel bacteria overgrowth
  • Total or partial gastrectomy
  • Diphyllobothrium latum infection
  • Helicobacter pylori infection
  • Pancreatic insufficiency
  • Malignancy of the pancreas or bowel
  • Dietary deficiency of vitamin B12
  • Transcobalamin II deficiency

Cyanocobalamin can be administered via intramuscular (IM) or subcutaneous (SC) routes.

Mechanism of Action1-3

Vitamin B12 is important for division and growth of the cell. It is converted to coenzyme B12 in the body and in this form facilitates the conversion of homocysteine to methionine (methylcobalamin) and plays an important role in converting methylmalonyl-coenzyme A to succinyl-Co-A (fatty acid and amino acid metabolism). Without coenzyme B12, tetrahydrofolate cannot be produced from 5-methyl tetrahydrofolate leading to folate deficiency. In addition, vitamin B12 is needed to produce myelin and is important for axon and nerve development. Gastrointestinal absorption of vitamin B12 depends on the presence of sufficient intrinsic factor and calcium ions.

Common1-3

  • Pruritus, transitory rash and a feeling of swelling (edema) of the entire body
  • Pain or redness at injection site
  • Headache

Contraindications1-3

  • Hypersensitivity or intolerance to cyanocobalamin or cobalt or its excipients
  • Aluminum; toxic aluminum concentrations may be seen with high doses, prolonged use, or renal dysfunction

Precautions1-3

  • Monitor for hypokalemia, after initial treatment, an increased red blood cell production may occur which may lower serum potassium levels
  • Use with caution in individuals with polycythemia vera or renal disease .

Store at 20°C to 25°C (68°F to 77°F). Do not freeze. Protect from light and moisture. Keep in original packaging and out of reach of children.

  1. Vasavada A, Patel P, Sanghavi DK. Cyanocobalamin. StatPearls. January 31. 2024. Accessed August 10, 2025. https://www.ncbi.nlm.nih.gov/books/NBK555964/
  2. Clinical Pharmacology Cyanocobalamin clinical monograph 2025 https://www.clinicalkey.com/pharmacology/ 
  3. Cyanocobalamin package insert. American Reagent January 2021. https://www.americanregent.com/media/3187/cyanocobalamin-insert-in0031-rev-1-2021.pdf Accessed August 10, 2025.

WPPL operates as a 503A compounding pharmacy and prepares individualized prescription medications pursuant to provider direction. Compounded preparations are not reviewed, tested, or approved by the FDA.

This listing also includes commercially manufactured products for convenience; these items are not compounded by our pharmacy and are sold as provided by their manufacturers. Actual products in stock at time of dispensing may vary due to supply chain variability. Any statements regarding non-compounded products are manufacturer-supplied, have not been evaluated by the FDA, and are not intended to diagnose, treat, cure, or prevent any disease. WPPL does not verify or endorse any therapeutic claims made by manufacturers. Please refer to original labeling for complete product information.

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