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Hydroxocobalamin Injection 1 mg/mL

Description

A sterile, red injectable solution of hydroxocobalamin (Vitamin B12), delivering 1 mg (1000 mcg) per mL. Used when oral B12 is ineffective or rapid action is needed.

Advantages

Highly Effective: Directly treats B12 deficiency (anemia, neurological issues).
Bypasses Malabsorption: Ideal for conditions like pernicious anemia or after gastric surgery.
Longer Retention: Stays in the body longer than some other B12 forms.
Cyanide Antidote: A crucial emergency treatment for cyanide poisoning.

Uses

Treats B12 Deficiency: For pernicious anemia, malabsorption, dietary deficiencies.
Corrects Macrocytic Anemia: Specifically megaloblastic anemia due to B12 lack.
Cyanide Poisoning: Emergency antidote.
Certain Optic Neuropathies: Related to B12 deficiency.

Nature

Hydroxocobalamin is a synthetic form of cobalamin (Vitamin B12), which is a complex, water-soluble organometallic compound containing a cobalt ion (Co3+) at its core. It is considered a precursor to the two biologically active coenzyme forms of vitamin B12 in the human body: methylcobalamin and adenosylcobalamin.

Its detailed mechanism of action is central to its physiological and therapeutic roles:

Direct Delivery and Conversion: When injected, hydroxocobalamin directly enters the systemic circulation, bypassing the intricate and often impaired gastrointestinal absorption process involving intrinsic factor. Once in the cells, hydroxocobalamin is efficiently converted into its two active coenzyme forms.
Role in Metabolic Pathways:
- Methylcobalamin Activity: As a coenzyme for the enzyme methionine synthase, methylcobalamin is vital for the remethylation of homocysteine to methionine. This reaction is intimately linked to the folate cycle, and a deficiency here can lead to a “folate trap,” where folate is metabolically trapped in an unusable form, impairing DNA synthesis and resulting in megaloblastic anemia. Methionine is also essential for the synthesis of S-adenosylmethionine (SAMe), a crucial methyl donor involved in numerous methylation reactions critical for neurological function, including the synthesis and maintenance of the myelin sheath.
- Adenosylcobalamin Activity: Functions as a coenzyme for methylmalonyl-CoA mutase, an enzyme involved in the catabolism (breakdown) of odd-chain fatty acids and branched-chain amino acids. Deficiency in this pathway leads to the accumulation of methylmalonic acid, a neurotoxic compound that is strongly implicated in the neurological manifestations of vitamin B12 deficiency.
Cyanide Detoxification (Specific to Hydroxocobalamin): A unique and life-saving property of hydroxocobalamin is its ability to directly bind to cyanide ions (CN−). The cyanide ion has an extremely high affinity for the cobalt ion within the hydroxocobalamin molecule. Upon binding, a stable and non-toxic compound, cyanocobalamin (the common form of vitamin B12 found in many supplements), is formed. Cyanocobalamin is then safely excreted by the kidneys. This rapid binding effectively sequesters cyanide, preventing it from inhibiting cellular respiration (specifically cytochrome c oxidase in the mitochondrial electron transport chain) and thereby reversing cyanide’s toxic effects.

Storage

Room Temperature: 20∘C to 25∘C.
Light-Sensitive: Keep in original carton.
Do Not Freeze.
Single-Dose: Discard unused portion.
Secure: Keep out of reach of children.
Check Expiry Date.