Generic Name: Cyanocobalamin

  • What is Nascobal?

    Nascobal nasal spray is a synthetic form of vitamin B12 that is used to maintain normal levels of vitamin B12 in patients with pernicious anemia who have no nervous system involvement.

    Nascobal is also used as a supplement for vitamin B12 deficiency that results from other conditions, including multiple sclerosis, HIV infection, AIDS, and Crohn's disease, as prescribed by your healthcare professional.

  • What is the most important information I should know about Nascobal?

    Low potassium levels as well as sudden death have been reported in severely anemic patients who were intensely treated with vitamin B12. Folic acid supplements are not a substitute for vitamin B12. Using only folic acid, instead of B12, may result in severe and irreversible neurological damage.

    Once beginning nasal therapy for anemia with Nascobal, you are required to take your weekly dose of this medication for the rest of your life. Failure to keep up with your therapy carries a serious risk of recurrence of anemia and potential damage to the nervous system.

    Return for follow-up blood tests every 3 to 6 months to measure vitamin B12 levels.

  • Who should not take Nascobal?

    Do not take Nascobal if you are allergic to cobalt and/or vitamin B12 or any other ingredient of this medication.
  • What should I tell my doctor before I take the first dose of Nascobal?

    Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Nascobal. Also, talk to your doctor about your complete medical history, especially about your daily diet; if you follow a strict vegetarian diet, you may be instructed to take Nascobal once per week.
  • What is the usual dosage?

    The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

    The usually dosage of Nascobal Nasal Spray is one spray (500 micrograms [mcg]) in one nostril once weekly.

  • How should I take Nascobal?

    Before the first dose and administration, the pump must be primed. Remove the clear plastic cover and the plastic safety clip from the pump. To prime the pump, place nozzle between the first and second finger with the thumb on the bottom of the bottle. Pump the unit firmly and quickly until the first appearance of spray. Then prime the pump an additional 2 times. Now the nasal spray is ready for use.

    The unit must be re-primed before each dose. Prime the pump once immediately before each administration of doses 2 through 8.

  • What should I avoid while taking Nascobal?

    Hot foods may cause nasal secretions and a resulting loss of medication; therefore, you should administer Nascobal at least one hour before or one hour after ingestion of hot foods or liquids.
  • What are possible food and drug interactions associated with Nascobal?

    If Nascobal is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Nascobal with the following: alcohol, antibiotics, colchicine, methotrexate, para-aminosalicylic acid, and pyrimethamine.
  • What are the possible side effects of Nascobal?

    Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

    Side effects may include: arthritis, anxiety, back pain, dizziness, general aching, headache, infection, nasal infection, nausea, runny nose, sore throat, upset stomach, vomiting

  • Can I receive Nascobal if I am pregnant or breastfeeding?

    If you are pregnant, planning to become pregnant, or are breastfeeding, talk to your doctor about taking Nascobal. Increased levels of vitamin B12 are needed while pregnant and nursing.
  • What should I do if I miss a dose of Nascobal?

    Do not miss your weekly dose of Nascobal. Notify you physician if you do miss a dose. Never take a double dose.
  • How should I store Nascobal?

    Store Nascobal upright at room temperature and protect from light.