Hydroxocobalamin G.L. Pharma (Hydroxocobalamin)

Hydroxocobalamin is used to correct cobalamin deficiency and its clinical consequences.

• Vitamin B12 deficiency: restores normal hematologic parameters and prevents anemia.
• Cobalamin deficiency anemia: corrects macrocytic anemia and supports red blood cell production.
• Peripheral neuropathy due to B12 deficiency: improves neurologic function and reduces neuropathic symptoms.

• Hydroxocobalamin acts as a cofactor for the enzymes methionine synthase and methylmalonyl‑CoA mutase. By facilitating the conversion of homocysteine to methionine and methylmalonyl‑CoA to succinyl‑CoA, it supports DNA synthesis, red blood cell formation, and myelin production, thereby correcting the metabolic disturbances of vitamin B12 deficiency.

Hydroxocobalamin may be associated with several adverse reactions, ranging from mild to severe.

Common Side Effects

• Injection site pain: mild discomfort at the site of administration.
• Redness or swelling: localized erythema or edema.
• Headache: transient headache following injection.
• Nausea: occasional feeling of nausea.
• Dizziness: mild vertigo or light‑headedness.

Serious or Rare Side Effects

• Anaphylactic reaction: severe allergic response requiring immediate medical attention.
• Hypotension: sudden drop in blood pressure after injection.
• Thrombophlebitis: inflammation of a vein with clot formation at the injection site.
• Seizures: rare neurologic events.
• Acute hemolysis: rapid destruction of red blood cells.

When using Hydroxocobalamin, certain precautions should be observed to ensure safety and efficacy.

• Assess deficiency: confirm vitamin B12 deficiency before initiating therapy.
• Monitor blood counts: regularly check hemoglobin and hematocrit levels.
• Watch neurologic status: evaluate for improvement or worsening of neuropathy.
• Adjust in renal impairment: consider dose modification in severe renal dysfunction.
• Avoid in known hypersensitivity: do not administer to patients with previous allergic reactions to cobalamin.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Hydroxocobalamin can interact with other medicines, affecting their efficacy or safety.

Major Interactions (Avoid)

• Metformin: may mask B12 deficiency, requiring monitoring.
• Proton pump inhibitors: reduce absorption of oral B12, less relevant for injection but may affect overall status.

Moderate Interactions (Monitor Closely)

• Nitrous oxide exposure: can inactivate cobalamin, increasing risk of deficiency.
• Anticonvulsants (e.g., phenytoin): may interfere with B12 metabolism.
• Folate supplements: high doses may mask hematologic signs of B12 deficiency.