Depovit B12 Uses

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What is Depovit B12?

Depovit B12 contains Hydroxocobalamin, a form of vitamin B-12. It is used as an antidote to cyanide poisoning. Depovit B12 works by helping cells in the body convert cyanide to a form that can be removed from the body through urination.

Depovit B12 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.

Depovit B12 may also be used for purposes not listed in this medication guide.

Depovit B12 indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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Indication

Depovit B12 is indicated for the treatment of known or suspected cyanide poisoning.

Identifying Patients with Cyanide Poisoning

Cyanide poisoning may result from inhalation, ingestion, or dermal exposure to various cyanide-containing compounds, including smoke from closed-space fires. Sources of cyanide poisoning include hydrogen cyanide and its salts, cyanogenic plants, aliphatic nitriles, and prolonged exposure to sodium nitroprusside.

The presence and extent of cyanide poisoning are often initially unknown. There is no widely available, rapid, confirmatory cyanide blood test. Treatment decisions must be made on the basis of clinical history and signs and symptoms of cyanide intoxication. If clinical suspicion of cyanide poisoning is high, Depovit B12 should be administered without delay.

Table 1 : Common Signs and Symptoms of Cyanide Poisoning

Symptoms Signs
  • Headache
  • Confusion
  • Dyspnea
  • Chest
  • tightness
  • Nausea
  • Altered Mental Status (e.g., confusion, disorientation)
  • Seizures or Coma
  • Mydriasis
  • Tachypnea / Hyperpnea (early)
  • Bradypnea / Apnea (late)
  • Hypertension (early) / Hypotension (late)
  • Cardiovascular collapse
  • Vomiting
  • Plasma lactate concentration ≥ 8 mmol/L

In some settings, panic symptoms including tachypnea and vomiting may mimic early cyanide poisoning signs. The presence of altered mental status (e.g., confusion and disorientation) and/or mydriasis is suggestive of true cyanide poisoning although these signs can occur with other toxic exposures as well.

The expert advice of a regional poison control center may be obtained by calling 1-800-222-1222.

Smoke Inhalation

Not all smoke inhalation victims will have cyanide poisoning and may present with burns, trauma, and exposure to other toxic substances making a diagnosis of cyanide poisoning particularly difficult. Prior to administration of Depovit B12, smoke-inhalation victims should be assessed for the following:

Although hypotension is highly suggestive of cyanide poisoning, it is only present in a small percentage of cyanide-poisoned smoke inhalation victims. Also indicative of cyanide poisoning is a plasma lactate concentration ≥ 10 mmol/L (a value higher than that typically listed in the table of signs and symptoms of isolated cyanide poisoning because carbon monoxide associated with smoke inhalation also contributes to lactic acidemia). If cyanide poisoning is suspected, treatment should not be delayed to obtain a plasma lactate concentration.

Use with Other Cyanide Antidotes

Caution should be exercised when administering other cyanide antidotes simultaneously with Depovit B12, as the safety of co-administration has not been established. If a decision is made to administer another cyanide antidote with Depovit B12, these drugs should not be administered concurrently in the same intravenous line.

How should I use Depovit B12?

Use Depovit B12 kit as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Depovit B12 kit.

Uses of Depovit B12 in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
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Use: Labeled Indications

IM injection: Treatment of pernicious anemia; treatment of vitamin B (eg, during neoplastic treatment)

IV infusion (Depovit B12): Treatment of cyanide poisoning (known or suspected)

Off Label Uses

Vasoplegic syndrome

Data from multiple case reports and a case series suggest that use of Depovit B12 may be beneficial in the treatment of vasoplegic syndrome and may be used as an alternative to or in patients who are refractory to methylene blue, in patients with glucose-6-phosphate dehydrogenase deficiency, or risk factors for serotonin syndrome during cardiac surgery.

Depovit B12 description

Injectable form of vitamin B 12 that has been used therapeutically to treat vitamin B 12 deficiency. [PubChem]

Depovit B12 dosage

Depovit B12 Dosage

Generic name: Depovit B12 2.5g in 100mL

Dosage form: injection

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Comprehensive treatment of acute cyanide intoxication requires support of vital functions. Depovit B12 should be administered in conjunction with appropriate airway, ventilatory and circulatory support.

Recommended Dosing

The starting dose of Depovit B12 for adults is 5 g (i.e., both 2.5g vials) administered as an intravenous (IV) infusion over 15 minutes (approximately 15 mL/min), i.e., 7.5 minutes/vial. Depending upon the severity of the poisoning and the clinical response, a second dose of 5 g may be administered by IV infusion for a total dose of 10 g. The rate of infusion for the second dose may range from 15 minutes (for patients in extremis) to two hours, as clinically indicated.

Preparation of Solution for Infusion

Each 2.5 g vial of Depovit B12 for injection is to be reconstituted with 100 mL of diluent (not provided with Depovit B12) using the supplied sterile transfer spike. The recommended diluent is 0.9% Sodium Chloride injection (0.9% NaCl). Lactated Ringers injection and 5% Dextrose injection (D5W) have also been found to be compatible with Depovit B12 and may be used if 0.9% NaCl is not readily available. The line on each vial label represents 100 mL volume of diluent. Following the addition of diluent to the lyophilized powder, each vial should be repeatedly inverted or rocked, not shaken, for at least 30 seconds prior to infusion.

Depovit B12 solutions should be visually inspected for particulate matter and color prior to administration. If the reconstituted solution is not dark red or if particulate matter is seen after the solution has been appropriately mixed, the solution should be discarded.

Incompatability Information

​Physical incompatibility (particle formation) and chemical incompatibility were observed with the mixture of Depovit B12 in solution with selected drugs that are frequently used in resuscitation efforts. Depovit B12 is also chemically incompatible with sodium thiosulfate and sodium nitrite and has been reported to be incompatible with ascorbic acid. Therefore, these and other drugs should not be administered simultaneously through the same IV line as Depovit B12.

Simultaneous administration of Depovit B12 and blood products (whole blood, packed red cells, platelet concentrate and/or fresh frozen plasma) through the same IV line is not recommended. However, blood products and Depovit B12 can be administered simultaneously using separate IV lines (preferably on contralateral extremities, if peripheral lines are being used).

Storage of Reconstituted Drug Product

Once reconstituted, Depovit B12 is stable for up to 6 hours at temperatures not exceeding 40°C (104°F). Do not freeze. Any reconstituted product not used by 6 hours should be discarded.

More about Depovit B12 (Depovit B12)

Consumer resources

Professional resources

Related treatment guides

Depovit B12 interactions

See also:
What other drugs will affect Depovit B12?

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The following values may be affected, in vitro, following Depovit B12 5 g dose. Interference following Depovit B12 10 g dose can be expected to last up to an additional 24 hours. Note: Extent and duration of interference dependent on analyzer used and patient variability (Shapeton 2019).

Falsely elevated:

Basophils, hemoglobin, MCH, and MCHC [duration: 12-16 hours]

Albumin, alkaline phosphatase, cholesterol, creatinine, glucose, total protein, and triglycerides [duration: 24 hours]

Bilirubin [duration: up to 4 days]

Urinalysis: Glucose, protein, erythrocytes, leukocytes, ketones, bilirubin, urobilinogen, nitrite [duration: 2-8 days]

Falsely decreased: ALT and amylase [duration: 24 hours]

Unpredictable:

AST, CK, CKMB, LDH, phosphate, and uric acid [duration: 24 hours]

PT (quick or INR) and aPTT [duration: 24-48 hours]

Urine pH [duration: 2-8 days]

May also turn both the plasma and urine a pinkish color and interfere with colorimetric or spectrophotometric tests (Wong 2016); may cause hemodialysis machines to shut down due to false detection of a blood leak from the blood-like appearance of the solution.

Depovit B12 side effects

See also:
What are the possible side effects of Depovit B12?

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Applies to Depovit B12: intravenous powder for solution

In addition to its needed effects, some unwanted effects may be caused by Depovit B12 (the active ingredient contained in Depovit B12). In the event that any of these side effects do occur, they may require medical attention.

If any of the following side effects occur while taking Depovit B12, check with your doctor or nurse immediately:

More common:

Incidence not known:

Minor Side Effects

Some of the side effects that can occur with Depovit B12 may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:

Incidence not known:

Depovit B12 contraindications

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What is the most important information I should know about Depovit B12?

If possible before you receive Depovit B12, 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 Depovit B12, 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.

This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you have recently received a Depovit B12 injection.

You may develop an acne-like skin rash within 1 to 4 weeks after you are treated with Depovit B12. This rash should go away without treatment. Call your doctor if you have a rash that lasts longer than 4 weeks.

If your skin turns red after receiving this medication, avoid exposure to sunlight or tanning beds. Depovit B12 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.



Active ingredient matches for Depovit B12:

Hydroxocobalamin in Ethiopia, Peru.


List of Depovit B12 substitutes (brand and generic names)

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Unit description / dosage (Manufacturer)Price, USD
Depo-B12 2.5 mg/1 mL x 2 mL x 100's
Depovitan B12 1000 1 mg/1 mL x 1 mL
Depovitan B12 1000 1 mg/1 mL x 10 mL
Injectable; Injection; Vitamin B12 / Hydroxocobalamin Acetate 0.5 mg / ml
Dodecavit 1 mg/2 mL x 2 mL x 6 tube
Injectable; Injection; Vitamin B12 / Hydroxocobalamin Acetate 0.5 mg / ml
Dodecavit 1 mg/2 mL x 2 mL x 6 tube
Injectable; Injection; Vitamin B12 / Hydroxocobalamin Acetate 0.5 mg / ml
Dodecavit 1 mg/2 mL x 2 mL x 6 tube
Injectable; Injection; Vitamin B12 / Hydroxocobalamin 1 mg (Atlantis)
Hi-Ohb12 5 mg/1 mL x 1 mL
Hilamin 5 mg/1 mL x 1 mL
Hilamin 5 mg/1 mL x 2 mL
Hycobamin 2.5 mg/1 mL x 2 mL
Hycomb 5 mg/1 mL x 2 mL x 100's
Hycomin / Vial 2.5 mg/1 mL x 10 mL x 50's
Hycomin / Ampoule 2.5 mg/1 mL x 2 mL x 100's
Hycomin -S 5 mg/1 mL x 2 mL
Injectable; Injection; Vitamin B12 / Hydroxocobalamin 1 mg / ml (Pasadena)
Hydro-B12 2.5 mg/1 mL x 2 mL
Hydroxo-B12 1 mg/1 mL x 1 mL
Hydroxo-B12 1 mg/1 mL x 10 mL
Hydroxobam 2.5 mg/1 mL x 2 mL
Hydroxobam 2.5 mg/1 mL x 10 mL
Injectable; Injection; Vitamin B12 / Hydroxocobalamin 1 mg / ml

Reviews

The results of a survey conducted on ndrugs.com for Depovit B12 are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Depovit B12. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.

User reports

1 consumer reported useful

Was the Depovit B12 drug useful in terms of decreasing the symptom or the disease?
According to the reports released by ndrugs.com website users, the below mentioned percentages of users say the drug is useful / not useful to them in decreasing their symptoms/disease. The usefulness of the drug depends on many factors, like severity of the disease, perception of symptom, or disease by the patient, brand name used [matters only to a certain extent], other associated conditions of the patient. If the drug is not effective or useful in your case, you need to meet the doctor to get re-evaluated about your symptoms/disease, and he will prescribe an alternative drug.
Users%
Useful1
100.0%


1 consumer reported price estimates

Was the price you paid to purchase the drug reasonable? Did you feel it was expensive?
The below mentioned numbers have been reported by ndrugs.com website users about whether the Depovit B12 drug is expensive or inexpensive. There is a mixed opinion among users. The rating about the cost of the drug depends on factors like which brand drug the patient purchased, how effective it was for the price paid, the country or place the drug is marketed, and the economic condition of the patient. The users who feel the drug is expensive can look for an alternative brand drug or a generic drug to save the cost.
Users%
Expensive1
100.0%


5 consumers reported time for results

To what extent do I have to use Depovit B12 before I begin to see changes in my health conditions?
As part of the reports released by ndrugs.com website users, it takes 1 week and a few days before you notice an improvement in your health conditions.
Please note, it doesn't mean you will start to notice such health improvement in the same time frame as other users. There are many factors to consider, and we implore you to visit your doctor to know how long before you can see improvements in your health while taking Depovit B12. To get the time effectiveness of using Depovit B12 drug by other patients, please click here.
Users%
1 week3
60.0%
5 days1
20.0%
1 month1
20.0%


7 consumers reported age

Users%
1-52
28.6%
16-292
28.6%
46-602
28.6%
30-451
14.3%


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Information checked by Dr. Sachin Kumar, MD Pharmacology

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