Hydroxocobalamin
/api/v1/drug/hydroxocobalaminMechanism of action
Sourced from openFDAMechanism-of-action class: Enzyme Interactions.
Contraindications
Sourced from openFDA- Hydroxocobalamin Injection is contraindicated in patients with known hypersensitivity to hydroxocobalamin, vitamin B12 preparations, cobalt, benzyl alcohol, or any component of the formulation. Hypersensitivity reactions, including anaphylactic shock and serious allergic reactions, have been reported following parenteral administration of hydroxocobalamin and other vitamin B12 products.contraindicated
Warnings & precautions
Sourced from openFDAHypersensitivity reactions, including anaphylactic shock, rash, pruritus, urticaria, and edema, have been reported following parenteral administration of vitamin B12 products, including hydroxocobalamin. Patients with known sensitivity to hydroxocobalamin, cobalt, benzyl alcohol, or any component of the formulation may be at increased risk for serious allergic reactions. This product contains benzyl alcohol as a preservative. Benzyl alcohol has been associated with serious and fatal adverse reactions, including “gasping syndrome,” in premature infants and neonates. Administer under appropriate medical supervision. Monitor patients for signs and symptoms of hypersensitivity during administration. Do not use if the solution is cloudy, discolored, or contains particulate matter. Use aseptic technique during handling and administration. Protect from light. Not for intravenous administration.
Adverse reactions
Sourced from openFDAThe following adverse reactions have been reported with hydroxocobalamin injection and other parenteral vitamin B12 products: Hypersensitivity reactions including anaphylactic shock, urticaria, rash, pruritus, flushing, and edema Injection site pain, erythema, and injection site reactions Headache and dizziness Nausea and diarrhea Fever and chills Rare cases of hypokalemia during intensive treatment of severe megaloblastic anemia Serious hypersensitivity reactions, including anaphylaxis, may occur in sensitive patients. To report suspected adverse reactions, contact Xseer Pharmaceuticals at (888) 658-8005 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch
Approval history
Sourced from openFDA- Aug 16, 1978ANDAANDA085998Actavis
- Dec 15, 2006NDANDA022041Btg Intl
FDA shortages
Reference statistics from the openFDA drug-shortage dataset. For a live view, consult the FDA database directly. Not clinical guidance.
- Cyanokit, Injection, 5 g/250mL (NDC 50633-310-11)ActiveSponsor: BTG International Inc. · Reason: Requirements related to complying with good manufacturing practicesUpdated
- Hydroxocobalamin, Injection, 1000 MCG/ML, 30 ML Multi-Dose Vial (NDC 0591-2888-30)ActiveSponsor: Teva Pharmaceuticals USA, Inc. · Reason: OtherUpdated
FAERS reports
- 1Acute Kidney Injury2075.1%
- 2Diarrhoea1984.9%
- 3Nausea1944.8%
- 4Dyspnoea1884.7%
- 5Dizziness1734.3%
- 6Vomiting1664.1%
- 7Off Label Use1594.0%
- 8Malaise1503.7%
- 9Hyponatraemia1373.4%
- 10Fatigue1263.1%
- 11Confusional State1193.0%
- 12Rash1182.9%
- 13Somnolence1132.8%
- 14Drug Ineffective1042.6%
- 15Headache1012.5%
Literature
Recent PubMed references pinned to Hydroxocobalamin as a MeSH major topic. Citations link to pubmed.ncbi.nlm.nih.gov.
- Analysis of hydroxocobalamin dosage in patients with CblC deficiency.Orphanet journal of rare diseases · 2025 · Ding S, Deng Y, Ding Y, et al.PMID 40841656DOI 10.1186/s13023-025-03991-y
- Targeting the contributors to vasorelaxation during vasoplegia from cardiopulmonary bypass.British journal of anaesthesia · 2025 · Wieruszewski PM, Ortoleva JPPMID 40841221DOI 10.1016/j.bja.2025.07.052
- Efficacy of Treating Nifedipine-Induced Shock with Hydroxocobalamin in a Swine Model.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2025 · Murphy C, Runyon M, Gellar M, et al.PMID 40760267DOI 10.1007/s13181-025-01089-2
- Hydroxocobalamin for vasoplegia in cardiac surgery: a retrospective cohort analysis.British journal of anaesthesia · 2025 · Zakaria L, Shah K, Yang D, et al.PMID 40634185DOI 10.1016/j.bja.2025.05.026
- Biologic rationale and evidence for high-dose hydroxocobalamin in septic shock.Current opinion in critical care · 2025 · Patel JJ, Carr J, Willoughby R, et al.PMID 40522117DOI 10.1097/MCC.0000000000001289
- Evaluation of the Binding Affinity of Nitrosylcobalamin to Intrinsic Factor as a Predictive Model for Cobalamin Binding Protein Interactions: A Comparative Study with Hydroxocobalamin.Frontiers in bioscience (Elite edition) · 2025 · Sysel AM, Bauer JAPMID 40150986DOI 10.31083/FBE26810
- Use of Hydroxycobolamin in the Prevention of Vasoplegic Syndrome in Adult Patients Undergoing Cardiopulmonary Bypass: A Controlled Prospective Trial.Journal of cardiothoracic and vascular anesthesia · 2025 · Salah D, Ahmed S, Ibrahim DA, et al.PMID 40055025DOI 10.1053/j.jvca.2025.02.001
- Hydroxocobalamin Versus Methylene Blue for Treatment of Vasoplegic Shock Following Cardiopulmonary Bypass: A Systematic Review and Meta-analysis.Journal of cardiothoracic and vascular anesthesia · 2024 · Cadd M, Watson U, Kilpatrick T, et al.PMID 39438181DOI 10.1053/j.jvca.2024.09.135
Clinical trials
The 10 most recently updated of 719 ClinicalTrials.gov registrations naming Hydroxocobalamin as an intervention. Registration is not evidence of efficacy or safety — reference crosswalk only.
- Host-Diet-Gut Interaction Post Vegan Diet in Pediatric Autoimmune Hepatitis.Recruiting · Interventional · 40 enrolled · Institute of Liver and Biliary Sciences, IndiaNCT07118657updated 2026-06-12
- Assessment of the Hemodynamic Effect of Hydroxocabalamin in Refractory Vasodilatory ShockCompleted · Observational · 18 enrolled · Centre Hospitalier Universitaire, AmiensNCT04964492updated 2026-06-12
- Clinical and Laboratory Study of Methylmalonic AcidemiaRecruiting · Observational · 2,275 enrolled · National Human Genome Research Institute (NHGRI)NCT00078078updated 2026-06-11
- Comparison of Internal Rotation, Local Cold and ShotBlocker on Intramuscular Injection Pain and ComfortCompleted · Interventional · 215 enrolled · MEDICANANCT07623421updated 2026-06-03
- Biological Optimization Versus Standard Care in Post-POEM Achalasia Patients (BIO-POEM)Active not recruiting · Interventional · 166 enrolled · Asian Institute of Gastroenterology, IndiaNCT07620899updated 2026-06-02
- Immune-Mitochondrial Correction in Military RecruitsNot yet recruiting · Interventional · 200 enrolled · MIPO ClinicNCT07622147updated 2026-06-02
- Anemia Therapy in Patients With Infective EndocarditisRecruiting · Phase 4 · Interventional · 74 enrolled · Rigshospitalet, DenmarkNCT07523646updated 2026-05-29
- A Trial of Vitamin B12 in Septic ShockCompleted · Phase 2 · Interventional · 20 enrolled · Medical College of WisconsinNCT03783091updated 2026-05-27
- Vitamin B Complex for Inferior Alveolar Nerve Paresthesia RecoveryNot yet recruiting · Phase 4 · Interventional · 50 enrolled · University of Sao PauloNCT07592897updated 2026-05-20
- Impact of a Novel Functional Snack on Perimenopausal Symptoms and Well-beingRecruiting · Interventional · 20 enrolled · King's College LondonNCT07599930updated 2026-05-20
Frequently asked questions
- How does Hydroxocobalamin work?
- Mechanism-of-action class: Enzyme Interactions.
- What class of drug is Hydroxocobalamin?
- Hydroxocobalamin is classified as Antidotes, Vitamin B12 (cyanocobalamin and analogues), Antidote, Enzyme Interactions, Cellular Activity Alteration.
- What are the brand names for Hydroxocobalamin?
- Hydroxocobalamin is marketed under brand names including Cyanokit.
- What are the contraindications for Hydroxocobalamin?
- Hydroxocobalamin labeling lists contraindications including: Hydroxocobalamin Injection is contraindicated in patients with known hypersensitivity to hydroxocobalamin, vitamin B12 preparations, cobalt, benzyl alcohol, or any component of the formulation. Hypersensitivity reactions, including anaphylactic shock and serious allergic reactions, have been reported following parenteral administration of hydroxocobalamin and other vitamin B12 products.. Always consult the full prescribing information and a clinician.
hydroxocobalamin is illustrative MVP content compiled from public sources. pharmacopeia is for educational and informational use only and is not a substitute for professional medical advice.