Cyanocobalamin Administration Guidelines

Introduction to Cyanocobalamin Therapy

• Local injection site reactions are possible with any intramuscular injection, though not specifically quantified in the literature for this dose 1

Dosing and Administration

• The American College of Nutrition recommends that the 2000 mcg daily dose for one week exceeds standard guideline recommendations, which typically suggest 1000 mcg on alternate days or three times weekly for initial treatment 2

Special Considerations

• The National Kidney Foundation suggests that cyanocobalamin should be avoided in patients with renal dysfunction due to potential accumulation of the cyanide moiety and increased cardiovascular risk; methylcobalamin or hydroxocobalamin are preferred alternatives in this population 4