Long COVID Patterns in the RECOVER-Adult Study
November 21, 2025
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Brand Name :
Cobex, B-12, Vitafusion B-12, Nascobal, Athlete, Calomist, Eligen B12, Rubramin PC, Vibisone
Synonyms :
Vitamin B12
Class :
Vitamins, Water soluble vitamins
Brand Name :
Cobex, B-12, Vitafusion B-12, Nascobal, Athlete, Calomist, Eligen B12, Rubramin PC, Vibisone
Synonyms :
Vitamin B12
Class :
Vitamins, Water soluble vitamins
Dosage Forms & StrengthsÂ
TabletsÂ
100mcgÂ
250mcgÂ
500mcgÂ
1000mcgÂ
Extended-release tabletsÂ
1000mcgÂ
Sublingual tabletÂ
2500mcgÂ
Injectable solutionÂ
1000mcg/mlÂ
Nasal sprayÂ
500mcg/sprayÂ
25 - 2000
mcg
Tablets
Orally 
every 24 hours
25 - 2000
mcg
Tablets
Orally 
every 24 hours
Flushing dose:
1000
mcg
Solution
Intramuscular (IM)
as needed
Dosage Forms & StrengthsÂ
TabletsÂ
100mcgÂ
250mcgÂ
500mcgÂ
1000mcgÂ
Extended-release tabletsÂ
1000mcgÂ
Sublingual tabletÂ
2500mcgÂ
Injectable solutionÂ
1000mcg/mlÂ
Nasal sprayÂ
500mcg/sprayÂ
0.5 - 3
mcg
every 24 hours
Refer to adult dosingÂ
Vitamin B12: they may increase the antiplatelet effect of antiplatelet agents
Vitamin B12: they may increase the antiplatelet effect of antiplatelet agents
Vitamin B12: they may increase the antiplatelet effect of antiplatelet agents
Vitamin B12: they may increase the antiplatelet effect of antiplatelet agents
Vitamin B12: they may increase the antiplatelet effect of antiplatelet agents
the levels of serum potassium may be decreased when dichlorphenamide is taken with cyanocobalamin
by altering the gastrointestinal absorption, the activity of omadacycline may be reduced with cyanocobalamin
cyanocobalamin leads to a reduction in the rate of excretion of nitric oxide, which leads to an increased level of serum
chloramphenicol: they may decrease the therapeutic effect of Vitamin B12
cyanocobalamin might lead to a reduction in the rate of excretion of telavancin, potentially leading to elevated levels of serum
by altering the gastrointestinal absorption, the concentration of acetazolamide may be reduced with cyanocobalamin
by altering gastrointestinal absorption, the concentration of cyanocobalamin may be reduced with aspirin
by altering the gastrointestinal absorption, the concentration of cyanocobalamin may be reduced with balsalazide
by altering the gastrointestinal absorption, the concentration of cyanocobalamin may be reduced with carbamazepine
by altering the gastrointestinal absorption, the concentration of cyanocobalamin may be reduced with cimetidine
by altering the gastrointestinal absorption, the concentration of cyanocobalamin may be reduced with colchicine
by altering the gastrointestinal absorption, the concentration of cyanocobalamin may be reduced with dexlansoprazole
by altering metabolism, the concentration of cyanocobalamin may be reduced with estropipate
by altering the gastrointestinal absorption, the concentration of cyanocobalamin may be reduced with gabapentin
by altering the gastrointestinal absorption, the concentration of cyanocobalamin may be reduced with levetiracetam
increase the metabolism of pralatrexate
Actions and spectrum:Â
L-methylmalonyl-CoA mutase and Methionine synthase are enzymes that require vitamin B12 as a cofactor. The purines and pyrimidines that makeup DNA are synthesized with the help of methionine synthase. L-methylmalonyl-CoA mutase is a crucial reaction needed for the metabolism of both fat and protein.
It transforms L-methylmalonyl-CoA into succinyl-CoA during the breakdown of propionate. The neurological symptoms of a B12 deficiency are thought to be caused by an excess of methylmalonyl CoA resulting from the above reaction and a lack of vitamin B12 cofactor. Additionally required for the synthesis of hemoglobin is succinyl-CoA.Â
Frequency definedÂ
Dizziness (12%)Â
Headache (12%)Â
Arthralgia (12%)Â
Nasopharyngitis (12%)Â
Frequency not definedÂ
AngioedemaÂ
Pulmonary edemaÂ
DiarrheaÂ
Sore throatÂ
NervousnessÂ
GlossitisÂ
Congestive heart failureÂ
Black Box Warning Â
Not intended for use in patients with Leber’s optic atrophyÂ
Contraindication/Caution:Â
Contraindication:Â
HypersensitivityÂ
Pregnancy consideration:Â Â
USFDA pregnancy category: CÂ
Lactation:Â Â
It is not recommended as the drug is known to be excreted in breast milk.Â
Pregnancy category:Â Â
Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus `in either the first or second trimester.Â
Category B: There was a lack of studies on pregnant women and no evidence of risk to the fetus in animal experiments.  Â
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   Â
Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.  Â
Category X: Drugs listed in this category outweigh the risks over benefits. Hence, these categories of drugs need to be avoided by pregnant women.   Â
Category N: There is no data available for the drug under this category
Pharmacology:Â
Pharmacodynamics:Â
Cyanocobalamin is a coenzyme, and it assists in various metabolic processes such as the protein synthesis and the metabolism of carbohydrates.Â
It also contributes to hematopoiesis and cell replication.Â
Pharmacokinetics:Â
AbsorptionÂ
Bioavailability- 6.1%Â
DistributionÂ
Cyanocobalamin is bound to transcobalamin and widely distributed to bone marrow, liver, etc.Â
Metabolism Â
Elimination and excretionÂ
The drug is primarily reabsorbed in the bile, and the excess amount is eliminated through urine. Â
Half-life:Â
Six days approx.Â
Administration:Â
It is administered orally or as an intramuscular solutionÂ
Patient information leafletÂ
Generic Name: cyanocobalamin Â
Why do we use cyanocobalmin?Â
Cyanocobalamin or vitamin B12 is used in the treatment of pernicious anemia, nutritional deficiency, etc. It is also used as an alternative medicine to treat canker sores, sleep disorders, cataracts, etc.Â
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