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Medicines > classes: [[:Category:Vitamins|Vitamin]] & routes : IM or intranasal

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generic:
Cyanocobalamin (vitamin B12) (1) · Folic acid (folate, pteroylglutamic acid) (1)
brand:
Folvite; mostly generic (1) · Many OTC and Rx; Nascobal (intranasal); generic injection (1)
classes: (Click arrow to add another value)
mechanism:
None (2)
uses:
'"`UNIQ--vote-000005B3-QINU`"', '"`UNIQ--vote-000005B4-QINU`"', '"`UNIQ--vote-000005B5-QINU`"', '"`UNIQ--vote-000005B6-QINU`"' (1) · '"`UNIQ--vote-00000607-QINU`"', '"`UNIQ--vote-00000608-QINU`"', '"`UNIQ--vote-00000609-QINU`"', '"`UNIQ--vote-0000060A-QINU`"' (1)
starting dose:
0.4 mg PO daily (general prevention); 0.8-1 mg/d in pregnancy; 4 mg/d for women with prior NTD-affected pregnancy; 1 mg/d during methotrexate therapy (1) · Replacement: 1000 mcg IM daily for 1 week, then weekly for 4 weeks, then monthly; or 1000-2000 mcg PO daily (effective even in pernicious anemia via passive diffusion); intranasal 500 mcg weekly (1)
preparations:
0.4, 0.8, 1 mg OTC; 1 mg Rx; 5 mg/mL injection (1) · 100, 250, 500, 1000, 5000 mcg tablets (OTC and Rx); 1000 mcg/mL injection; intranasal spray; sublingual (1)
fda max:
1 mg/d typical Rx; higher in specific indications (1) · No strict ceiling; water-soluble vitamin, low toxicity (1)
routes: (Click arrow to add another value)
onset:
Hematologic response within days (1) · Reticulocyte response at 3-5 days; neurologic recovery weeks to months (and may be incomplete if longstanding) (1)
duration:
N/A (replacement) (2)
halflife:
~0.5 hours plasma; tissue retention longer (1) · ~6 days (plasma); hepatic stores last 3-5 years (1)
bioavailability:
High (oral) (1) · Oral ~1-3% via passive diffusion at high doses (independent of intrinsic factor); IM/SC ~100% (1)
pregnancy:
Routinely supplemented in pregnancy and preconception to prevent neural tube defects.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Routinely supplemented in vegan pregnancies and pernicious anemia.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)
legal:
OTC (low-dose) and [[USLegal:Prescription only|Rx-only]] (1 mg, injectable) in US (1) · OTC (low/mid-dose oral) and [[USLegal:Prescription only|Rx-only]] (injection, intranasal) in US (1)

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