Cyanokit

DRUG DESCRIPTION

Hydroxocobalamin, the active ingredient in Cyanokit, is cobinamide dihydroxide dihydrogen phosphate (ester), mono (inner salt), 3'-ester with 5,6-dimethyl-1-?-D-ribofuranosyl-1H-benzimidazole. The drug substance is the hydroxylated active form of vitamin B12 and is a large molecule in which a trivalent cobalt ion is coordinated in four positions by a tetrapyrol (or corrin) ring. It is a hygroscopic, odorless, dark red, crystalline powder that is freely soluble in water and ethanol, and practically insoluble in acetone and diethyl ether. Hydroxocobalamin has a molecular weight of 1346.36 atomic mass units, an empirical formula of C62H89CoN13O15P and the following structural formula:

Cyanokit® (hydroxocobalamin) Structural Formula
 Illustration

Cyanokit (hydroxocobalamin for injection) 5 g for intravenous infusion is a cyanide antidote package which contains one colorless 250 mL glass vial, containing 5 g dark red lyophilized hydroxocobalamin, pH adjusted with hydrochloric acid, one transfer spike, one intravenous administration set, one quick use reference guide and one package insert.

The 5 g vial of hydroxocobalamin for injection is to be reconstituted with 200 mL of 0.9% NaCl, to give a dark red injectable solution (25 mg/mL). If 0.9% NaCl is not readily available, 200 mL of either Lactated Ringers injection or 5% Dextrose injection (D5W) may be used as the diluent. Diluent is not included in the Cyanokit. The pH of the reconstituted product ranges from 3.5 to 6.0.

What are the possible side effects of hydroxocobalamin (Cyanokit)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure);
  • fast or uneven heart rate;
  • bright red blood in your stools; or
  • swelling in your hands or feet.

Less serious side effects are...

Read All Potential Side Effects and See Pictures of Cyanokit »


Cyanokit Patient Information Including Side Effects

Brand Names: Cyanokit

Generic Name: hydroxocobalamin (injection) (Pronunciation: hye DROX o koe BAL a min)

  • What is hydroxocobalamin (Cyanokit)?
  • What are the possible side effects of hydroxocobalamin (Cyanokit)?
  • What is the most important information I should know about hydroxocobalamin (Cyanokit)?
  • What should I discuss with my health care provider after receiving hydroxocobalamin (Cyanokit)?
  • How should I take hydroxocobalamin (Cyanokit)?
  • What happens if I miss a dose (Cyanokit)?
  • What happens if I overdose (Cyanokit)?
  • What should I avoid while taking hydroxocobalamin (Cyanokit)?
  • What other drugs will affect hydroxocobalamin (Cyanokit)?
  • Where can I get more information?

What is hydroxocobalamin (Cyanokit)?

Hydroxocobalamin is a form of vitamin B-12. It is used as an antidote to cyanide poisoning. Hydroxocobalamin works by helping cells in the body convert cyanide to a form that can be removed from the body through urination.

Hydroxocobalamin is used in an emergency to treat cyanide poisoning. This type of poisoning can occur if you are exposed to smoke from a house or industrial fire, if you swallow or breathe in cyanide, or if you get cyanide on your skin.

Hydroxocobalamin may also be used for purposes other than those listed in this medication guide.

What are the possible side effects of hydroxocobalamin (Cyanokit)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure);
  • fast or uneven heart rate;
  • bright red blood in your stools; or
  • swelling in your hands or feet.

Less serious side effects are more likely to occur, such as:

  • red coloring of your skin or urine (this may last up to 2 weeks);
  • nausea, vomiting, diarrhea, stomach pain;
  • acne, skin rash or itching;
  • warmth or redness under your skin;
  • dry throat, trouble swallowing;
  • headache, dizziness, memory problems, restless feeling;
  • pain, swelling, or irritation of your skin where the injection was given; or
  • eye redness or irritation.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about hydroxocobalamin (Cyanokit)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Hydroxocobalamin is usually given in an emergency, so you may not have time to tell your caregivers about any drugs you take or medical conditions you have. However, you will need follow-up medical care after receiving this medication. Tell your doctor if you have high blood pressure, heart disease, or congestive heart failure.

You may develop an acne-like skin rash from 1 week to as late as 4 weeks after you are treated with hydroxocobalamin. This rash should go away without treatment. Call your doctor if you have a rash that does not clear up on its own.

This medication can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you have recently received a hydroxocobalamin injection.

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