Hydroxocobalamin (Vitamin B12)

That is exactly this page's primary indication (B12 replacement) by exactly this page's primary route (IM), and Cobalin-H is one of the page's two listed IM brands. || VERBATIM §4.2, every published figure: 'The following dosages are suitable for children and adults.' 'Addisonian pernicious anaemia and other macrocytic anaemias without neurological involvement: Initially: 250 micrograms to 1000 micrograms intramuscularly on alternate days for one or two weeks then 250 micrograms weekly until blood count is normal. Maintenance: 1000 micrograms every two or three months.' 'Addisonian pernicious anaemia and other macrocytic anaemias with neurological involvement: Initially: 1000 micrograms on alternate days as long as improvement continues. Maintenance: 1000 micrograms every two months.' 'Prophylaxis of macrocytic anaemias associated with vitamin B 12 deficiency resulting from gastrectomy, ileal resection, certain ma/absorption states and vegetarianism: 1000 micrograms every two or three months.' (The source prints 'ma/absorption'; read as malabsorption.) || NO MAXIMUM DOSE IS PRINTED anywhere in §4.2 or §4.4, so maxDose is deliberately empty — none has been derived by arithmetic from the regimen. || FOURTH INDICATION IN THE SAME SECTION, not published here because it is not this page's indication: 'Tobacco amblyopia and Leber's optic atrophy: Initially: 1000 micrograms daily by intramuscular injection for two weeks then twice weekly as long as improvement is maintained. Maintenance: 1000 micrograms every three months or as required.' ⚠️ CONFLICT WORTH KNOWING: the US label in this bundle says the opposite — 'Administration to patients with hereditary optic nerve atrophy (Leber's disease) may result in severe and rapid optic nerve atrophy' — and lists it as a contraindication. Check both labels before treating that indication. || BEFORE TREATING, §4.4 verbatim: 'It is advisable to confirm the diagnosis of Vitamin B 12 deficiency before giving hydroxocobalamin; regular monitoring of the blood is recommended. If megaloblastic anaemia fails to respond, folate metabolism should be investigated. Doses in excess of 10 micrograms daily may produce a haematological response in patients with folate deficiency. Indiscriminate administration may mask the true diagnosis.' And: 'Cardiac arrhythmias secondary to hypokalaemia during initial therapy have been reported. Plasma potassium should therefore be monitored during this period.' || PRODUCT STRENGTH: Cobalin-H 1000 microgram/ml, i.e. 1000 micrograms (1 mg) in 1 ml, so a 1000 microgram dose is 1 ml and a 250 microgram dose is 0.25 ml.

dosePerKg IS NULL AND MUST STAY NULL: the SPC's paediatric dosing is a fixed microgram regimen, not weight-based, so no weight calculator may run on it and none does (the calculator returns nothing when dosePerKg is null). These are the label's own paediatric figures, stated as suitable for children — nothing has been scaled from the adult dose. concentration 1000 is the source product's strength, Cobalin-H 1000 microgram/ml, so the page renders 'Concentration: 1000 micrograms/ml'. ⚠️ The US label in this bundle warns that its product 'contains benzyl alcohol as a preservative. Benzyl alcohol has been associated with serious and fatal adverse reactions, including "gasping syndrome," in premature infants and neonates' — check the excipients of the actual product in use before giving it to a neonate. Verify any paediatric or neonatal use against a children's formulary and specialist paediatric haematology advice.