Nascobal 500 mcg/spray nasal spray

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Medication name

Generic name:
Cyanocobalamin - nasal

Pronunciation
(SYE-an-oh-koe-BAL-a-min)

Brand name(s)
Nascobal

Uses

Cyanocobalamin is a man-made form of vitamin B12 used to treat low levels (deficiency) of this vitamin. Vitamin B12 helps your body use fat and carbohydrates for energy and make new protein. It is also important for normal blood, cells, and nerves. Most people get enough vitamin B12 in their diet, but a deficiency may occur in certain health conditions (such as poor nutrition, pregnancy, stomach/intestinal problems, infection, cancer). Serious vitamin B12 deficiency may result in anemia, stomach problems, and nerve damage.

How to use

Read the Patient Information Leaflet provided by your pharmacist before you start using this medication and each time you get a refill. Follow the illustrated directions for the proper use of this medication. If you have any questions, ask your doctor or pharmacist.

Gently blow your nose before using this drug. If your product needs to be primed, follow the instructions on how to properly prime the bottle.

Use this medication in the nose as directed by your doctor, usually once weekly. Hot food or drinks may produce mucus that can wash away this medication. Avoid hot food or drinks for 1 hour before or after using this medication.

For products that contain more than 1 dose, keep track of the number of doses you use from each pump.

The dosage is based on your medical condition and response to treatment. Do not increase, decrease, or stop this medication without your doctor's approval. Use this medication regularly to get the most benefit from it. To help you remember, use it on the same day each week. Mark your calendar with a reminder.

Side effects

Headache, nausea, or runny nose may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication may cause low potassium levels in the blood (hypokalemia). Tell your doctor right away if any of these serious side effects occur:

  • muscle cramps
  • weakness
  • irregular heartbeat

People who have a rare blood disorder (polycythemia vera) may rarely have symptoms related to this disorder while taking cyanocobalamin. Get medical help right away if any of these very serious symptoms occur:

  • chest pain (especially with shortness of breath)
  • weakness on one side of the body
  • sudden vision changes
  • trouble speaking

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

  • rash
  • itching/swelling (especially of the face/tongue/throat)
  • severe dizziness
  • trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before using cyanocobalamin, tell your doctor or pharmacist if you are allergic to it; or to cobalt; or if you have any other allergies. Your doctor may recommend that you receive a smaller test dose before starting your regular dose. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

  • low potassium blood levels (hypokalemia)
  • gout
  • a certain blood disorder (polycythemia vera)
  • a certain eye disease (Leber's disease)
  • other vitamin/mineral deficiencies (especially folic acid and iron)

Tell your doctor if you develop a stuffy or runny nose (such as due to a common cold or allergies) while using this medication. You may need to use another form of vitamin B12 when these symptoms are present.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

Based on information from related drugs, this medication may pass into breast milk. Consult your doctor before breastfeeding.

Drug interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Overdose

Overdose with this medication is very unlikely. However, if someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669.

Notes

Do not share this medication with others.

Lab and/or medical tests (such as blood potassium levels, complete blood count, hematocrit, vitamin B12 levels) should be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.

This product is not a substitute for a proper diet. Remember that it is best to get your vitamins from healthy foods. Vitamin B12 is commonly found in many foods from animals, especially liver, kidney, fish and shellfish, meat, and dairy foods.

Missed dose

If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

Storage

Store the pump upright at room temperature away from light and moisture. Do not freeze. Do not store in the bathroom. Discard the pump after you have used the labeled number of doses on the product package. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Important note

HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

Information last revised October 2024.

Selected from NATIONAL DRUG DATA FILE (NDDF) data included with permission and copyrighted by First Databank, Inc., 2019. This copyrighted material has been downloaded from a licensed data provider.

The above information is intended to supplement, not substitute for, the expertise and judgment of your health care professional. You should consult your health care professional before taking any drug, changing your diet, or commencing or discontinuing any course of treatment.