Hydroxocobalamin
Administration
- Type: Antidote
- Dosage Forms: IV
- Routes of Administration: IV
- Common Trade Names: Cyanokit
Adult Dosing
Cyanide toxicity
- 5g IV x1
- May repeat x1 if needed
- Total doses up to 20g have been used
Pediatric Dosing
Cyanide toxicity
- 70 mg/kg IV x1
- Max: 5g/single dose (adults)
- May repeat x1 if needed
- Total doses up to 20g have been used in adults
Special Populations
- Pregnancy Rating: C; Benefits outweigh risks during pregnancy
- Lactation risk: L3; Safety unknown
Renal Dosing
- Adult: Not defined
- Pediatric: Not defined
Hepatic Dosing
- Adult: Not defined
- Pediatric: Not defined
Contraindications
- Allergy to class/drug
- Caution if hypersensitive to cyanocobalamin
- Caution if hemodialysis
Adverse Reactions
Serious
- Hypersensitivity reaction
- HTN
- Hematochezia
Common
- Red urine
- Erythema
- Rash, acneiform
- Transient BP elevation
- Nausea
- Headache
- Leukopenia
- Infusion site reaction
- Ocular irritation
- Dysphagia
- Abdominal discomfort
- Vomiting
- Diarrhea
- Dyspepsia
- Peripheral edema
- Chest discomfort
- Impaired memory
- Dizziness
- Restlessness
- Dyspnea
- Pruritus/Urticaria
- Dry throat
- Photosensitivity
Pharmacology
- Half-life: 26-31h
- Metabolism: Unknown
- Excretion: Urine
Mechanism of Action
- Metalloprotein that binds cyanide to form nontoxic cyanocobalamin then is excreted in urine
Comments
- Restricted distribution in US directly for authorized EMS, emergency preparedness, or occupational medicine users
See Also
- Cyanide toxicity
- Hydrogen Sulfide
- Chemical weapons
- Hazmat exposure
References
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