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vitamin b12

Generic
Used for Vitamin B12 Deficiency
Used for Vitamin B12 Deficiency

Vitamin B12 (cyanocobalamin) is a dietary supplement used to treat low blood vitamin B12 levels (vitamin B12 deficiency). It's available as a pill and liquid that's typically taken by mouth once per day. But depending on your specific situation, your provider might have you take a different dosage. Vitamin B12 (cyanocobalamin) is generally well tolerated and doesn't have many side effects.

Reviewed by:
reviewer
Robert Chad Hakim, PharmD, BCCCP
reviewer
Kristianne Hannemann, PharmD
Last reviewed on August 7, 2023
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostAlternativesLatest newsImagesReferencesPricesMedicare
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What is Vitamin B12 (cyanocobalamin)?

What is Vitamin B12 (cyanocobalamin) used for?

How Vitamin B12 (cyanocobalamin) works

Vitamin B12 (cyanocobalamin) is a dietary supplement. Your body needs vitamin B12 (cyanocobalamin) for several processes, such as promoting red blood cell growth, maintaining nerve cell health, and making DNA (genetic material).

Are you looking for information on Nascobal (cyanocobalamin) nasal spray or cyanocobalamin injection instead?

Drug Facts

Common BrandsNo brand name available
Drug ClassDietary supplement
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityOver-the-counter

More on Vitamin B12 (cyanocobalamin) essentials

Health: Vitamin B-12: flat lay foods rich in B12-1130686240

Vitamin B12: Overview, Benefits, and Food Sources

Written by Katie E. Golden, MD
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What are the side effects of Vitamin B12 (cyanocobalamin)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

See Risks and Warnings.

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Serious allergic reaction: rash; trouble breathing; swelling of the lips, tongue, or face; vomiting

Source: DailyMed

The following side effects have also been reported

Side effects that you should report to your care team as soon as possible:

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

pros-and-cons

Pros and cons of Vitamin B12 (cyanocobalamin)

thumbs-up

Pros

Can help restore vitamin B12 levels if you're not getting enough from your diet

Taken by mouth once per day

Available over the counter in many different forms (e.g., pill, gummy, liquid)

thumbs-down

Cons

Not labeled for use in children younger than 18 years of age

Many different dosages available, which can be confusing

Some forms (e.g., liquids, gummies) contain sugar

pharmacist-tips

Pharmacist tips for Vitamin B12 (cyanocobalamin)

pharmacist

  • Discuss with your provider whether you're getting enough vitamin B12 from your diet or if you should take a vitamin B12 (cyanocobalamin) supplement.

    • For the fast-dissolvable tablets, make sure your hands are dry before handling the medication. Place the tablet on the tongue to let it dissolve, and swallow with saliva. Don't swallow the fast-dissolving tablets whole. You don't need to drink water when taking a fast-dissolving tablet.

      • For the liquid, use the measuring device that's included in the packaging to measure your dose of vitamin B12 (cyanocobalamin). This can sometimes be a dropper, medication dose cup, or an oral syringe. Ask your pharmacy to provide you with one if the product doesn't include it in its packaging or if you lose it. Don't use household spoons because they might not be accurate and might cause you to take the wrong dose. Follow the directions on the product labeling or your provider's instructions.

        • You can take vitamin B12 (cyanocobalamin) with or without food. Check your product's labeling or with your provider for specific recommendations.

          • Vitamin B12 (cyanocobalamin) is found in many other multivitamins and supplements. Make sure to read labels carefully on all of the dietary supplements you're taking to see if it contains vitamin B12 (cyanocobalamin).

            • Keep vitamin B12 (cyanocobalamin) out of reach of children so that they don't accidentally take it. If your child accidentally took vitamin B12 (cyanocobalamin), call your local Poison Control Center right away at 1-800-222-1222.

              More on Vitamin B12 (cyanocobalamin) tips

              Vitamin B12: 1202593967310987.hqhCPLDqwvtPzaWJ1qU8 height640

              How Much Vitamin B12 is Too Much?

              Written by Rachel Feaster, PharmD, BCOP, BCPS
              faqs

              Frequently asked questions about Vitamin B12 (cyanocobalamin)

              What is vitamin B12 (cyanocobalamin) good for?
              Vitamin B12 (cyanocobalamin) has three major roles in the body. It helps your body make red blood cells to help prevent a condition called anemia. Vitamin B12 (cyanocobalamin) also keeps nerve cells healthy so that they work well. In addition, this vitamin is needed for your body to make DNA. Let your provider know if you have symptoms like headaches, dizziness, changes in vision, tingling in the arms or legs, and problems with balance. These can be symptoms of low vitamin B12 levels. Your provider can check your vitamin B12 levels and discuss with you whether you need vitamin B12 (cyanocobalamin) supplementation.
              How much vitamin B12 (cyanocobalamin) should I take?
              The recommended amount of vitamin B12 (cyanocobalamin) that you need per day differs based on your age and whether you're pregnant or breastfeeding. But in general, the recommended daily intake of vitamin B12 for adults is 2.4 mcg to 2.8 mcg per day. Most people can get enough vitamin B12 (cyanocobalamin) from their diet, but some people might need help to do so by taking supplements. Vitamin B12 (cyanocobalamin) supplements can contain amounts much higher than your body typically needs, like 1,000 mcg per day. But your body only absorbs a small portion of this amount. Depending on your specific situation (e.g., your vitamin B12 level, medical history), your provider might have you take a different dosage of vitamin B12 (cyanocobalamin).
              Can you take too much vitamin B12 (cyanocobalamin)?
              It's usually not really a concern if you take too much vitamin B12 (cyanocobalamin). This is because it's a water-soluble vitamin. If you take too much vitamin B12 (cyanocobalamin) and your body doesn't need it, it'll typically get removed from your body through your urine. But to be safe from possible side effects, contact a poison control center at 1-800-222-1222 for help if you're worried that you or a loved one has taken too much vitamin B12 (cyanocobalamin).
              Where do you get vitamin B12 (cyanocobalamin) from?
              Vitamin B12 (cyanocobalamin) is found in several types of foods, such as beef, seafood, poultry, and dairy products. It's also found in foods that are fortified with vitamin B12, such as nutritional yeasts and some breakfast cereals. In terms of manufactured forms of vitamin B12, it's often found in different types of vitamins and dietary supplements. Check the manufacturer's label of any dietary supplement or vitamin you're taking to see how much vitamin B12 (cyanocobalamin) you're getting.
              When is the best time to take vitamin B12 (cyanocobalamin)?
              You can take vitamin B12 (cyanocobalamin) supplements at any time of the day and with or without food. Take vitamin B12 (cyanocobalamin) whenever is most convenient for you when you won't forget to take any doses.
              What's the difference between cyanocobalamin and methylcobalamin?
              Methylcobalamin is simply the active form of vitamin B12. When you take vitamin B12 (cyanocobalamin), it gets changed into methylcobalamin in the body. When compared to one another, both forms of vitamin B12 appear to work similarly for most people. Talk with your provider about which form of vitamin B12 is best for you.
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              What are the risks and warnings for Vitamin B12 (cyanocobalamin)?

              Vitamin B12 (cyanocobalamin) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

              risk-warning

              Allergic reactions

              Allergic reactions to vitamin B12 (cyanocobalamin) are possible, including life-threatening reactions like facial swelling, shock, and anaphylaxis (e.g., closing of the throat). If you notice difficulty breathing, a choking sensation, swelling around your eyes, swelling of the lips or tongue, dizziness, or nausea after using vitamin B12 (cyanocobalamin), get medical attention right away.

              risk-warning

              Not recommended for people with Leber’s disease (a rare genetic eye condition)

              People with a rare, inherited eye condition called Leber's disease who received vitamin B12 developed severe eye damage. Vitamin B12 (cyanocobalamin) products isn't recommended in people with Leber's disease. If you have Leber's disease, speak with your provider about alternatives for vitamin B12 supplementation.

              risk-warning

              Close monitoring needed for people with severe pernicious anemia

              If you have pernicious anemia, discuss with your provider whether vitamin B12 (cyanocobalamin) supplements that are taken by mouth are right for you. Sometimes, treating severe pernicious anemia with vitamin B12 can cause serious problems, like low potassium and high platelet levels. If you do, your provider will follow up with you more often. They'll track your potassium and platelet levels through bloodwork during treatment with vitamin B12 (cyanocobalamin). Contact your provider if you notice headache, confusion, shortness of breath, heart palpitations (chest pounding), muscle weakness or cramps, or unusual bleeding. These can be symptoms of electrolyte or platelet problems.

              risk-warning

              Potential to hide anemia due to low folic acid

              • Risk factors: Taking more than 10 mcg of vitamin B12 daily

                Taking vitamin B12 can sometimes mask anemia due to low folic acid levels). This means that vitamin B12 might help raise your red blood cell count without affecting your folic acid (folate) levels (so your folic acid levels will still be low). Your provider will check your folic acid levels through bloodwork before you start vitamin B12 (cyanocobalamin) to make sure you receive appropriate treatment for all your nutrient deficiencies.

                dosage

                Vitamin B12 (cyanocobalamin) dosage forms

                The average cost for 30 tablets of 1000mcg of Vitamin B12 (cyanocobalamin) is $3.30 with a free GoodRx coupon. This is 71.96% off the average retail price of $11.79.
                tablet
                Tablet
                DosageQuantityPrice as low asPrice per unit
                100mcg90 tablets$5.46$0.06
                250mcg90 tablets$6.37$0.07
                500mcg90 tablets$4.06$0.05
                1000mcg30 tablets$3.30$0.11

                Typical dosing for Vitamin B12 (cyanocobalamin)

                The typical dose ranges from 100 mcg to 5,000 mcg once a day (preferably with food).

                Keep in mind that vitamin B12 (cyanocobalamin) is available in many different forms (e.g., oral tablets, orally dissolving tablets, gummies, lozenges). Vitamin B12 (cyanocobalamin) also comes in different strengths. For these reasons, each vitamin B12 (cyanocobalamin) supplement can have different directions on how to take.

                Please read the manufacturer's label for directions that are specific to the vitamin B12 (cyanocobalamin) product you have or follow your provider's instructions. Your provider might recommend a dose of vitamin B12 (cyanocobalamin) that's different from the manufacturer's label.

                Your provider might adjust your dose based on your vitamin B12 levels, whether you have medical conditions that cause lower vitamin B12 levels (e.g., Crohn's disease), or whether you're taking other medications that affect vitamin B12 levels.

                interactions

                Interactions between Vitamin B12 (cyanocobalamin) and other drugs

                Vitamin B12 (cyanocobalamin) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Vitamin B12 (cyanocobalamin). Please note that only the generic name of each medication is listed below.

                Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

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                How much does Vitamin B12 (cyanocobalamin) cost?

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                Vitamin B12 (cyanocobalamin) (generic)
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                alternatives

                What are alternatives to Vitamin B12 (cyanocobalamin)?

                There are a number of medications that your doctor can prescribe in place of Vitamin B12 (cyanocobalamin). Compare a few possible alternatives below.
                Vitamin B12 (cyanocobalamin)
                Used for:
                $3.30 Lowest GoodRx priceView Prices
                Nascobal (cyanocobalamin)
                Used for:
                $174.27 Lowest GoodRx priceView Prices
                Cyanocobalamin (Dodex)
                Used for:
                $10.13 Lowest GoodRx priceView Prices
                latest news

                What is the latest news about Vitamin B12 (cyanocobalamin)?

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                Vitamin B12 (cyanocobalamin) images

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                This medicine is Red Vial.red - Cyanocobalamin 10000mcg / 10mL Solution for Injection
                red - Cyanocobalamin 1000mcg / ml Solution for Injection
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                red - Cyanocobalamin 10000mcg / 10mL Solution for Injection
                This medicine is Red Vial.red - Cyanocobalamin 10000mcg / 10mL Solution for Injection

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                References

                Best studies we found

                Allen, L. H. (2012). Vitamin B-12. Advances in Nutrition.

                American Society of Hematology. (n.d.). Blood basics.

                Ankar, A., et al. (2022). Vitamin B12 deficiency. StatPearls.

                View All References (13)

                Calderón-Ospina, C. A., et al. (2020). B vitamins in the nervous system: Current knowledge of the biochemical modes of action and synergies of thiamine, pyridoxine, and cobalamin. Central Nervous System Neuroscience & Therapeutics.

                Devalia, V., et al. (2014). Guidelines for the diagnosis and treatment of cobalamin and folate disorders. British Journal of Haemotology.

                Gomollón, F., et al. (2017). Oral cyanocobalamin is effective in the treatment of vitamin B12 deficiency in Crohn's disease. Nutrients.

                Marlex Pharmaceuticals Inc. (2020). B - 12- cyanocobalamin tablet [package insert]. DailyMed.

                MedlinePlus. (2022). Folate-deficiency anemia.

                Miller, J. W. (2018). Proton pump inhibitors, H2-receptor antagonists, metformin, and vitamin B-12 deficiency: Clinical implications. Advances in Nutrition.

                National Heart, Lung, and Blood Institute. (2022). Thrombocythemia and thrombocytosis.

                National Institutes of Health, Office of Dietary Supplements. (2021). Vitamin B12: Fact sheet for consumers.

                National Institutes of Health, Office of Dietary Supplements. (2022). Vitamin B12: Fact sheet for health professionals.

                National Organization for Rare Disorders. (2008). Anemia, pernicious.

                Par Pharmaceutical, Inc. (2018). Nascobal- cyanocobalamin spray [package insert]. DailyMed.

                Paul, C., et al. (2017). Comparative bioavailability and utilization of particular forms of B12 supplements with potential to mitigate B12-related genetic polymorphisms. Integrative Medicine.

                Shemesh, A., et al. (2022). Leber hereditary optic neuropathy (LHON). StatPearls.

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