Cyanocobalamin (Vitamin B12) Nasal gel

What is this medicine?

CYANOCOBALAMIN (sye an oh koe BAL a min) is a man made form of vitamin B12. Vitamin B12 is used in the growth of healthy blood cells, nerve cells, and proteins in the body. It also helps with the metabolism of fats and carbohydrates. This medicine is used to treat people who can not absorb enough vitamin B12.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• Leber's disease
• low amounts of iron or folic acid in your blood
• megaloblastic anemia
• nasal congestion from allergies or infection
• an unusual or allergic reaction to cyanocobalamin, cobalt, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine?

This medicine is for use in the nose only. Follow the directions on the prescription label. You may not get the full dose of this medicine if you have a runny nose. Do not use this medicine for at least one hour before or after hot foods or liquids. Talk to your doctor if you get a runny nose from allergies or a cold. Do not use more often than directed. Make sure that you are using your nasal gel correctly. Ask you doctor or health care provider if you have any questions.

A patient information sheet for the product will be given with each prescription and refill. Read this sheet carefully each time. The sheet may change frequently.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, use it as soon as you can. If it is almost time for your next dose, use only that dose. Do not use double or extra doses.

What may interact with this medicine?

• alcohol
• aminosalicylic acid
• colchicine
• medicines that suppress your bone marrow like chemotherapy, chloramphenicol

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Visit your doctor or health care professional regularly. You may need blood work done while you are taking this medicine.

You may need to follow a special diet. Talk to your doctor. Limit your alcohol intake and avoid smoking to get the best benefit from this medicine.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• breathing problems
• chest tightness, pain
• dizziness
• fever, infection
• pain, swelling, warmth in the leg

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• headache
• nausea
• runny nose

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children.

Store the container upright at room temperature between 15 and 30 degrees C (59 and 85 degrees F). Protect from light. Keep in carton until ready to use. Do not freeze. Throw away any unused medicine after the expiration date.

NOTE:This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.