Dosing and uses of Cyanokit (hydroxocobalamin)
Adult dosage forms and strengths
lyophilized powder for reconstitution
- 5g/vial
Cyanide Poisoning
Drug of choice in continental Europe/Australia
70 mg/kg (usually 5 g) IV infusion over 15 minutes; additional 5 g IV may be given
Not to exceed a cumulative dose of 10 g
Pediatric dosage forms and strengths
lyophilized powder for reconstitution
- 5g/vial
Cyanide Poisoning (Off-label)
Safety and efficacy not established; in non-US marketing experience, a dose of 70 mg/kg IV over 15 minutes has been used
Cyanokit (hydroxocobalamin) adverse (side) effects
Frequency not defined
Flushing
Anaphylaxis
Red skin & urine
Pregnancy and lactation
Pregnancy category: C
Lacatation: excretion in milk unknown; use with caution
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Cyanokit (hydroxocobalamin)
Mechanism of action
Vitamin B12 with hydroxyl group complexed to cobalt which can be displaced by cyanide resulting in cyanocobalamin that is renally excreted
Administration
IV Preparation
Reconstitute lyophilized powder with 200 mL 0.9% NaCl; resulting concentration is 25 mg/mL
