Trusted, medically reviewed health information • Not a substitute for medical advice
Medically Verified MonographOTCClass: Vitamin

Vitamin B12 (Methylcobalamin)

Generic Name: Methylcobalamin / Cyanocobalamin

Common Brand Names: Neurobion, Nurokind, Reclimet, Methylcobal
Dosage Form:Oral Sublingual Tablets, Capsules, IM / IV Injection
Route:Oral, Sublingual, Intramuscular
Pregnancy Category:Category A (Category C at high doses)
Last Reviewed:9/6/2026

Seek Urgent Medical Attention If:

Severe ataxia, progressive limb paralysis (subacute combined spinal degeneration).

Uses & Medical Indications

Treatment and prevention of Vitamin B12 deficiency, megaloblastic/macrocytic anemia, peripheral neuropathy, diabetic neuropathy, and post-gastrectomy or strict vegetarian/vegan nutritional replenishment.

Medical Conditions Treated:

Vitamin B12 Deficiency, Megaloblastic Anemia, Peripheral Neuropathy, Diabetic Neuropathy

Dosage & Administration Guidelines

Adult Dosage

Dietary deficiency / Maintenance: 1000 mcg to 1500 mcg orally once daily. Severe neurological symptoms / Malabsorption: 1000 mcg IM alternate days for 1-2 weeks, then weekly, then monthly maintenance.

Pediatric Dosage

Adjust based on age and severity (typically 5 to 50 mcg daily).

Elderly / Geriatric Considerations

1000 mcg daily orally or sublingually due to high prevalence of atrophic gastritis and hypochlorhydria.

Maximum Dose Limit

Water-soluble; excess is excreted harmlessly in urine.

Renal Impairment:

No adjustment required.

Hepatic Impairment:

No adjustment required.

Side Effects & Safety Warnings

Common Side Effects

Generally none; rare mild transient diarrhea or skin rash.

Serious Adverse Reactions

Extremely rare; hypokalemia during initial rapid reticulocyte proliferation in severe pernicious anemia.

Contraindications:

Hypersensitivity to cobalt or methylcobalamin.

Important Warnings & Precautions:

Folic acid alone must not be used to treat B12 deficiency; folate corrects the anemia but allows irreversible neurological spinal cord degeneration (subacute combined degeneration) to progress.

Interactions (Drugs, Food & Alcohol)

Drug-Drug Interactions:

Metformin, Proton Pump Inhibitors (Omeprazole, Pantoprazole), H2 Blockers, Colchicine (all reduce intestinal B12 absorption with chronic use).

Food & Dietary Interactions:

Can be taken with or without food.

Alcohol Interaction Warning:

Heavy alcohol consumption impairs intestinal B12 absorption and hepatic storage.

Pregnancy & Breastfeeding Safety

Pregnancy Safety

Safe and vital during pregnancy for fetal neural tube and brain development.

Breastfeeding / Lactation

Essential for nursing infants; strict vegetarian mothers must supplement to prevent infantile B12 deficiency.

Patient Counseling & Practical Advice

How to Take:

If using sublingual tablets, place under the tongue and allow to dissolve completely. Patients on long-term Metformin or Omeprazole should have B12 checked every 1-2 years.

What to Do if You Miss a Dose:

Take when remembered.

Recommended Monitoring & Lab Tests:

Complete blood count (MCV, hemoglobin), serum Vitamin B12, serum methylmalonic acid (MMA) or homocysteine.

Frequently Asked Questions

Related Medicines in Vitamin

Trustworthy Sources & Medical Review

Content for Vitamin B12 (Methylcobalamin) was synthesized and fact-checked against standardized regulatory monographs, official pharmacopoeias, and national health authorities:

  • NIH Office of Dietary SupplementsVitamin B12 Fact Sheet for Health Professionals
Reviewer Credentials: PharmD, Clinical PharmacologistLast Reviewed Date: 9/6/2026

The information provided on this website is for educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.