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cyanocobalamin

Generic Dodex
Used for Vitamin B12 Deficiency
Used for Vitamin B12 Deficiency

Cyanocobalamin (Dodex) is an injectable form of vitamin B12 that's used to treat low blood vitamin B12 levels (vitamin B12 deficiency). It can also help restore vitamin B12 levels in adults with anemia due to low vitamin B12. Cyanocobalamin (Dodex) is typically given as an injection through the skin or into the muscle. The dosage can vary and depends on why you need to take cyanocobalamin (Dodex). This medication is available as a lower-cost generic.

Last reviewed on August 8, 2023
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What is Cyanocobalamin (Dodex)?

What is Cyanocobalamin (Dodex) used for?

How Cyanocobalamin (Dodex) works

Cyanocobalamin (Dodex) is a form of vitamin B12. Vitamin B12 is important for several processes in your body, including these three major roles:

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

Drug Facts

Common BrandsDodex
Drug ClassVitamin
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only

More on Cyanocobalamin (Dodex) essentials

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What are the side effects of Cyanocobalamin (Dodex)?

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 Other Side Effects.

Other Side Effects

  • Itching
  • Diarrhea
  • Shortness of breath

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 Cyanocobalamin (Dodex)

thumbs-up

Pros

Works well to raise vitamin B12 levels

Typically given once daily to once monthly

Can be used in children

thumbs-down

Cons

Needs to be injected under the skin or into the muscle, which can be uncomfortable

Typically lifelong treatment with injections for pernicious anemia

Can cause aluminum toxicity since it contains aluminum

pharmacist-tips

Pharmacist tips for Cyanocobalamin (Dodex)

pharmacist
  • If your provider says it's okay to give yourself cyanocobalamin (Dodex) at home, make sure you understand how to give yourself the injections properly. If you have any questions, contact your pharmacist or healthcare provider.

    • If you're giving yourself cyanocobalamin (Dodex) at home, make sure to throw your vials and syringes in a sharps container to prevent needlestick injuries.

      • Mark your appointments in your calendar to see your provider and get any ordered blood tests drawn (e.g., potassium, vitamin B12, blood count). This will help you and your provider see how well cyanocobalamin (Dodex) is working for you and look for any side effects.

        • Discuss with your provider how much vitamin B12 you should be getting from your diet or other dietary supplements while taking cyanocobalamin (Dodex).

          • Vitamin B12 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 cyanocobalamin (Dodex).

            More on Cyanocobalamin (Dodex) tips

            faqs

            Frequently asked questions about Cyanocobalamin (Dodex)

            How long do I need to receive cyanocobalamin (Dodex)?
            Your provider will decide how long you need to take cyanocobalamin (Dodex). People with pernicious anemia generally continue treatment with cyanocobalamin (Dodex) once monthly for the rest of their life. But people using cyanocobalamin (Dodex) for other vitamin B12 deficiency conditions typically only use it if they can't take cyanocobalamin by mouth or if it's not working well enough. Eventually though, it might be possible to switch to the oral form after restoring vitamin B12 levels with cyanocobalamin (Dodex), as long as you don't have gut problems that interfere with absorption. Keep in mind that how long you'll need to take cyanocobalamin (Dodex) will also depend on other factors, including how well it's working for you.
            How quickly does cyanocobalamin (Dodex) work?
            Studies show that it takes about 1 hour for cyanocobalamin (Dodex) to reach the maximum amount in your body after one dose given into the muscle.
            Do I need to take vitamin B12 by mouth while I'm also taking cyanocobalamin (Dodex)?
            Not unless your provider specifically says you need to. Most people can get enough vitamin B12 from cyanocobalamin (Dodex) alone. Ask your provider if you need to take oral cyanocobalamin along with cyanocobalamin (Dodex) because it'll likely depend on your specific situation (e.g., your vitamin B12 level, medical history).
            Can I receive cyanocobalamin (Dodex) as an injection through the veins (IV)?
            No, cyanocobalamin (Dodex) is only given as an injection into the muscle or under the skin. It isn't given intravenously (IV). When the medication is given IV injection, cyanocobalamin (Dodex) can cause a severe allergic reaction (called anaphylaxis). In addition, your body will get rid of cyanocobalamin (Dodex) through your urine very quickly before any of it can be absorbed and used. If you're uncomfortable with cyanocobalamin (Dodex) injections, talk to your provider about potential other options for you.
            What's the difference between cyanocobalamin and hydroxocobalamin?
            Cyanocobalamin and hydroxocobalamin are two forms of vitamin B12. Studies haven't proven that one form of vitamin B12 is better than another for treating low vitamin B12 levels. But they do come in different dosage forms. Cyanocobalamin comes as oral, injectable, and nasal spray forms. On the other hand, hydroxocobalamin is only available as an intramuscular (IM) injection when used to treat low vitamin B12 levels.
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            What are the risks and warnings for Cyanocobalamin (Dodex)?

            Cyanocobalamin (Dodex) 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

            Severe allergic reactions

            Severe allergic reactions to cyanocobalamin (Dodex) are possible, including life-threatening reactions like facial swelling, shock, and anaphylaxis (closing of the throat). It's recommended that your provider give you a test dose of cyanocobalamin before starting treatment to determine whether you're at risk of having an allergic reaction to the medication. If you notice difficulty breathing, a choking sensation, swelling around your eyes, swelling of the lips or tongue, dizziness, or nausea after using cyanocobalamin (Dodex), 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 products containing cyanocobalamin, including cyanocobalamin (Dodex), 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 (like hydroxocobalamin).

            risk-warning

            Toxicity from too much aluminum

            • Risk factors: History of kidney problems | Babies who were born early (premature)

              Cyanocobalamin (Dodex) contains aluminum. Too much cyanocobalamin (Dodex) can cause high blood aluminum levels and can lead to aluminum toxicity. Your provider might order aluminum blood levels while you're taking cyanocobalamin (Dodex), especially if you have kidney problems since you're at higher risk. Contact your provider if you notice any signs or symptoms of aluminum poisoning (e.g., weakness, speech problems, bone pain, seizures).

              risk-warning

              Risk of serious breathing problem in infants (gasping syndrome)

              • Risk factors: Newborns | Infants with low birth weight | Pregnant people | Breastfeeding

                Certain cyanocobalamin (Dodex) products have a preservative called benzyl alcohol. This preservative can cause a rare, but serious and sometimes life-threatening medical condition called gasping syndrome. This condition is more likely to happen in newborns and infants with low birth weight. If you're pregnant or breastfeeding, talk with your provider before receiving cyanocobalamin (Dodex), since your baby could potentially be exposed to benzyl alcohol in the womb or through your breast milk. Tell your provider if your child experiences any major weight changes while receiving cyanocobalamin (Dodex). Get medical attention right away if your child has symptoms, such as gasping, slowed heart rate, clammy skin, seizures, or weakness in an arm or leg.

                risk-warning

                Close monitoring needed for people with severe pernicious anemia

                If you have severe pernicious anemia, your provider might monitor you more closely. Treating severe pernicious anemia with vitamin B12 can cause low potassium and high platelet levels. These conditions can be serious and life-threatening. Your provider will track your potassium and platelet levels through bloodwork during treatment with cyanocobalamin (Dodex). Don't use any other vitamin B12 supplement while taking cyanocobalamin (Dodex) unless your provider specifically instructs you to. 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 might check your folic acid levels through bloodwork to make sure you receive appropriate treatment for all your nutrient deficiencies.

                  dosage

                  Cyanocobalamin (Dodex) dosage forms

                  The average cost for 1 vial of 10ml of 1000mcg/ml of Cyanocobalamin (Dodex) is $10.13 with a free GoodRx coupon. This is 59.48% off the average retail price of $24.99.
                  carton
                  Carton
                  DosageQuantityPrice as low asPrice per unit
                  twenty-five 1ml vials of 1000mcg/ml1 carton$22.85$22.85
                  vial
                  Vial
                  DosageQuantityPrice as low asPrice per unit
                  1ml of 1000mcg/ml1 vial$5.51$5.51
                  10ml of 1000mcg/ml1 vial$10.13$10.13
                  30ml of 1000mcg/ml10 vials$153.78$15.38

                  Typical dosing for Cyanocobalamin (Dodex)

                  • Pernicious anemia (low red blood cell count due to low vitamin B12): The typical dose is 100 mcg injected into the muscle or under the skin once daily for 6 or 7 days. If your vitamin B12 levels improve, 100 mcg can be given on alternating days for 7 doses, then every 3 to 4 days for another 2 to 3 weeks. Then, you'll receive 100 mcg of cyanocobalamin (Dodex) once monthly lifelong.

                  • Low vitamin B12 levels that aren't due to gut problems: People who can't take the cyanocobalamin by mouth (for whatever reason) can receive cyanocobalamin (Dodex) for a short amount of time. Your provider will decide the dose based on how low your vitamin B12 levels are. You'll probably switch to the oral version of cyanobalamin for long-term treatment.

                  • Schilling test (vitamin B12 absorption test): The typical dose is 1,000 mcg injected into the muscle after taking an oral cyanocobalamin dose (taken by mouth).

                  More on Cyanocobalamin (Dodex) dosage forms

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                  contraindications-icon

                  Cyanocobalamin (Dodex) contraindications

                  Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Cyanocobalamin (Dodex) will not be safe for you to take.
                  • Allergy to cobalt or vitamin B12

                  alternatives

                  What are alternatives to Cyanocobalamin (Dodex)?

                  There are a number of medications that your doctor can prescribe in place of Cyanocobalamin (Dodex). Compare a few possible alternatives below.
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                  References

                  Best studies we found

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

                  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.

                  Hikma Pharmaceuticals USA Inc. (2023). Cyanocobalamin injection [package insert]. DailyMed.

                  View All References (13)

                  MedGen. (n.d.). Gasping syndrome. National Library of Medicine.

                  MedlinePlus. (2022). Folate-deficiency anemia.

                  MedlinePlus. (2022). Pernicious anemia.

                  MedlinePlus. (2022). Schilling test.

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

                  National Institutes of Health, Office of Dietary Supplements. (2023). Vitamin B12: Fact sheet for consumers.

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

                  Rahimzadeh, M. R., et al. (2022). Aluminum poisoning with emphasis on its mechanism and treatment of intoxication. Emergency Medicine International.

                  Ramphul, K., et al. (2023). Schilling test. StatPearls.

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

                  Vaqar, S., et al. (2023). Pernicious anemia. StatPearls.

                  Vasavada, A., et al. (2023). Cyanocobalamin. StatPearls.

                  Zagouri, F., et al. (2020). Supportive medication in cancer during pregnancy. Biomed Central Pregnancy and Childbirth.

                  GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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