![]() Bġ2r appears orange-brown in solution, while Bġ2s appears bluish-green under natural daylight, and purple under artificial light. Both Bġ2s are stable indefinitely under oxygen-free conditions. However, under reducing conditions, the cobalt center is reduced to Co(II) or even Co(I), which are usually denoted as Bġ2s, for reduced and super reduced, respectively.ġ2s can be prepared from cyanocobalamin by controlled potential reduction, or chemical reduction using sodium borohydride in alkaline solution, zinc in acetic acid, or by the action of thiols. In the cobalamins, cobalt normally exists in the trivalent state, Co(III). Reduced forms of Cyanocobalamin, with a Co(I) (top), Co(II) (middle), and Co(III) (bottom) The cyanide is converted to thiocyanate and excreted by the kidney. After consumption the cyanide ligand is replaced by other groups ( adenosyl, methyl) to produce the biologically active forms. The vitamin Bġ2 coenzymes are unstable in light. It is stable to autoclaving for short periods at 121 ☌ (250 ☏). Cyanocobalamin is hygroscopic in the anhydrous form, and sparingly soluble in water (1:80). It can be obtained as dark red crystals or as an amorphous red powder. It is the easiest to crystallize and therefore easiest to purify after it is produced by bacterial fermentation. Animals, including humans, can convert cyanocobalamin to any one of the active vitamin BĬyanocobalamin is one of the most widely manufactured vitamers in the vitamin Bġ2 family (the family of chemicals that function as Bġ2 when put into the body), because cyanocobalamin is the most air-stable of the Bġ2 forms. Chemistry ġ2 is the "generic descriptor" name for any vitamers of vitamin Bġ2. When treated with cyanocobalamin, patients with Leber's disease may develop serious optic atrophy, possibly leading to blindness. Treatment of megaloblastic anemia with concurrent vitamin Bġ2 vitamers (including cyanocobalamin), creates the possibility of hypokalemia due to increased erythropoiesis (red blood cell production) and consequent cellular uptake of potassium upon anemia resolution. Less-serious side effects may include headache, dizziness, leg pain, itching, or rash. Possible side effects of cyanocobalamin injection include allergic reactions such as hives, difficult breathing redness of the face swelling of the arms, hands, feet, ankles or lower legs extreme thirst and diarrhea. Cyanocobalamin is also used to perform the Schilling test to check ability to absorb vitamin BĬyanocobalamin is also produced in the body (and then excreted via urine) after intravenous hydroxycobalamin is used to treat cyanide poisoning. Cyanocobalamin injections are often prescribed to gastric bypass patients who have had part of their small intestine bypassed, making it difficult for Bġ2 to be acquired via food or vitamins. It is also used to treat pernicious anemia, vitamin Bġ2 deficiency (due to low intake from food or inability to absorb due to genetic or other factors), thyrotoxicosis, hemorrhage, malignancy, liver disease and kidney disease. ![]() Medical use Ĭyanocobalamin is usually prescribed after surgical removal of part or all of the stomach or intestine to ensure adequate serum levels of vitamin Bġ2. In 2020, it was the 105th most commonly prescribed medication in the United States, with more than 6 million prescriptions. It is available as a generic medication and over the counter. Ĭyanocobalamin was first manufactured in the 1940s. Vitamin Bġ2 is an essential nutrient meaning that it cannot be made by the body but is required for life. Use is not recommended in those who are allergic to cobalt or have Leber's disease. Serious side effects may include anaphylaxis, low blood potassium, and heart failure. Minor side effects may include diarrhea and itchiness. Ĭyanocobalamin is generally well tolerated. It is used by mouth, by injection into a muscle, or as a nasal spray. It is less preferred than hydroxocobalamin for treating vitamin Bġ2 deficiency. The deficiency may occur in pernicious anemia, following surgical removal of the stomach, with fish tapeworm, or due to bowel cancer. 12 deficiency except in the presence of cyanide toxicity.
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