B12 Ankermann Artesan Pharma treat anemia, neuralgia (2 blisters x 25 tablets)

Dosage form Box of 2 blisters x 25 tablets
Specifications Cyanocobalamin
Ingredient Artesan Pharma GmbH & Co., K.G - Germany

Ingredient

Composition information	Content
Cyanocobalamin	1000mcg

Uses

indications

Ankermann drugs are indicated in the following cases:

Treatment and prevent vitamin B12 deficiency. Treatment of vision loss caused by smoking and Leber's optical atrophy.

Treatment of birth errors of vitamin B12 metabolism.

Cyanid poisoning treatment.

ATC code: b03ba01.

Vitamin B12 is a methylmalonyl coa isomerase, essential to convert propionic acid into successor acid. Moreover, along with folic acid, vitamin B12 participates in the formation of methyl groups, these methyl groups are then transferred to methyl substances through transmethylation. Vitamin B12 also participates in the synthesis of nucleic acid, especially the process of hematopoietic and maturity of other cells in the body.

Prevention and need

Vitamin B12 is used for treatment purposes in the form of cyanocobalamin and/or hydroxocobalamin or hydroxocoacetate. These forms are all inactive, when entering the body will turn into a form of activity is methylcobalamin and 5-adenosylcobalamin.

The human body cannot synthesize vitamin B12 and must be absorbed from food. Foods containing vitamin B12 include liver, kidney, heart, fish, shellfish, milk, egg yolk and meat.

Signs of shortage

A decrease in vitamin B12 absorption, which can occur for many years, will lead to signs of vitamin B12 deficiency if plasma concentrations drop below 200 PG/ml. It is possible to see changes in blood formula in the form of huge red blood cell anemia. For nerves can cause damage to the peripheral and central nervous system. Signs of multi -nerve disease may appear along with post -spinal column lesions and mental disorders. The signs of vitamin B12 deficiency often include typical symptoms such as fatigue and pale, tingling in the arms and legs, unstable gait and physical reduction.

Symptoms caused by vitamin B12 deficiency can only be improved by vitamin B12 supplementation.

Today, high -dose vitamin B12 oral oral therapy (> 1000 µg/day) has the effect of reducing symptoms due to vitamin B12 deficiency.

Pharmacokinetics

Vitamin B12 is absorbed through two different paths:

Vitamin B12 is actively absorbed in the small intestine by attaching internal factors. Vitamin B12 is transported into tissues by attaching transcobalamin, which are plasma globulin beta groups.

Vitamin B12 can also absorb circulation by passive diffusion method through the gastrointestinal tract or mucous membrane without attachment to the intrinsic factor. About 1 - 3% of oral dose is absorbed at circulation, the amount of drug absorption increases proportional to the dose.

Therefore, when taking high doses (≥ 1000 µg/day), the amount of absorption drug meets the patient's needs even when the patient lacks internal factors.

With 10 -person physiological absorption of vitamin B12, passive absorption path, not attached to intrinsic factors, becomes more important.

Dosage (µg) The amount of vitamin B12 absorbed (µg) Dynamic R> 1000

10,484 1,498 8,99 The amount of drugs absorbed increases to absolute level when increasing the dose.

Vitamin B12 is stored in the body, mainly in the liver. The consumption of vitamin B12 according to the daily needs of the body is very low, only about 1 µg of the amount of metabolic drug in a day is 2.5 µg. The sale time is about 1 year, 2.55 µg of vitamin B12/day, equivalent to 0.051% of the total reserve in the body, used.

Vitamin B12 is excreted mainly through bile and the regression of the liver - intestines up to 1 µg. When the amount of reserves in the body exceeds the level of high doses, especially when used in the injection line, the excess will be eliminated through the urine.

When the body is healthy, the absorption of vitamin B12 is reduced, after 3-5 years, the symptoms of vitamin B12 deficiency.

Before taking B12 Ankermann Artesan Pharma treat anemia, neuralgia (2 blisters x 25 tablets)

How to use

should start treatment with injection if there is a serious neurological symptom.

Should take the pill with water, do not chew, it is best to drink in the morning when the stomach is empty.

Dosage

Dosage is determined by symptoms:

Symptoms of vitamin B12 deficiency TEACHERS/DAY TECHNIQUES TEACHER/DAY

For patients with malignant anemia, the doctor should decide the time to take the drug, especially the initial treatment time (usually 4 weeks). The time for drug use is determined based on the effectiveness of treatment and should be redefined by regular checks.

The use of vitamin B12 for patients who have been diagnosed with malignant anemia must be maintained for a lifetime.

used in adults

Unless otherwise prescribed, for adults, daily dose is a tablet of cyanocobalamin 1000 µg to treat clinical vitamin B12 deficiency. In severe cases, the recommended treatment starts with 2 tablets of cyanocobalamin 1000 µg. In the case of severe neurological symptoms, the beginning of injection.

used in children and teenagers

In children and teenagers, it is recommended to use oral cyanocobalamin at daily doses of up to 1000 µg as a replacement for vitamin B12 deficiency therapy by injection.

used in the elderly

Recommended the use of normal dose modes in the elderly.

Used in patients with renal failure

In patients with average renal failure, normal doses can use cyanocobalamin 1000 µg. In case of severe renal failure, the dose may be needed and should regularly monitor the serum vitamin B12 level.

used in patients with liver failure

There is no data on pharmacokinetics and clinical experience in patients with hepatic impairment. Safety and effectiveness in patients with hepatic failure.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose?

Vitamin B12 has a wide range of treatment. There is no case of poisoning or overdose symptoms. Cases of accidental overdose should be treated with symptoms, if necessary.

In case of emergency, call the 115 emergency center immediately or go to the nearest local health station.

What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double doses to compensate for missed dose.

Side Effects

When using B12 Ankermann medicine, you may experience unwanted effects (ADR) such as:

The following frequency data is established in evaluating unwanted effects:

Very common (≥ 1/10)

Common (≥ 1/100 to

Less (≥ 1/1,000 to

Rare (≥ 1/10,000 to

Very rare (

Unknown (not estimated from existing data)

Rare:

Systemic: Anaphylaxis, fever, headache, dizziness, bronchospasm, mouth angio - Most.

Skin exterior: Fish egg -like reactions, urticaria, erythema, itching.

Digestive: nausea.

Secondary arrhythmia due to hypokalemia at the beginning of treatment.

Instructions on how to handle ADR:

Notify the physician with unwanted effects when using the drug.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Ankermann drugs contraindicated in the following cases:

There is a history of allergies to cobalamine (vitamin B12 and related substances). Cyanocobalamin 1000 µg in patients who need to detoxify Cyanide (for example, patients with cigarette vision loss or neuritis after eyeball in malignant anemia).

Be cautious when using

need to be very careful when taking the drug for patients in the following cases:

It should be noted the following in case of hematopoietic disorders and/or neurological disorders:

Due to the serious nature of the disease and the sequelae may occur in an incomplete response or lack of patient compliance with the treatment plan, it is necessary to closely monitor the successful oral treatment. The recommendation is 7 days after the beginning of treatment, checking the number of mesh red blood cells, the number of blood cells (including hemoglobin -HB -HB and hematocrit concentrations) as well as the average volume of red blood cells (MCV). After that, the symptoms, the number of blood cells and the MCV should be monitored at 4 weeks in the first 3 months of treatment and at a distance of 6 months if the patient is well followed. If the patient is suspected of lack of compliance, may need to control more often.

Be cautious in patients with folic acid deficiencies. Folat deficiency can prevent treatment. In these patients, do not specify the use of Cyanocobalamin μg tablets.

Patients with rare genetic galactose intolerance, lactase deficiency, glucose-galactose malabsorption, rare genetic intolerance or sucrase-isomaltase deficiency should not use cyanocobalamin tablets 1000 µg.

The effect of the drug on driving and operating machinery

No report.

Use drugs for women during pregnancy and lactation

evidence that vitamin B12 supplements during pregnancy and lactation are at a very small risk for mothers and young children. However, Cyanocobalamin 1000 µg should not be used to treat huge red blood cell anemia during pregnancy due to folat deficiency.

Interactive drug

The absorption of vitamin B12 may be reduced due to proton pump inhibitors (for example: omeprazol), antagonistic H2 antagonists (for example: cimetidin), colchicin, neomycin, cholestyramine, kCl, methyldopan and para-amino-salicylic acid. Serum concentration may also be reduced by oral contraceptives, but this interaction is not clinically significant.

chloramphenicol can reduce the effect of vitamin B12 in anemia.

Steroid drugs, such as Prednison, have been reported to increase the absorption of vitamin B12 in malignant anemia patients.

Nitrous oxid (N2O) causes a shortage of vitamin B12.

BiguanID group (such as: metformin) can do tformin) reduces the concentration of vitamin B12 in serum.

Anti -metabolic substances and most antibiotics do not void the quantification of vitamin B12 by microorganisms.

Storage

Leave a cool place, avoid light, temperatures below 30⁰C.

To be out of reach of children, read the instructions carefully before use.

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