Intramuscular Cobalamin (Cyanocobalamin/Hydroxocobalamin)
Treatment for Vitamin B12 Deficiency
Typical Dosage: 1000 mcg IM daily/EOD for 1-2 weeks, then 1000 mcg IM monthly
Effectiveness
99%
Safety Score
85%
Clinical Trials
9
Participants
10K
Comparative Safety Scale(Higher is safer)
Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
85
DangerousModerateSafe
Treatment Details
Dosage Range
1000 mcg IM daily/EOD for 1-2 weeks, then 1000 mcg IM monthly
Time to Effect
Hematologic: 2-3 days; Symptomatic: 1-2 weeks; Neurological: Weeks to months
Treatment Duration
Initial loading then lifetime maintenance
Evidence Quality
HIGHConfidence Score
98%confidence in effectiveness data
Health Economics
Annual Cost of Care
Drug Cost:$100
Monitoring:$150
Side Effect Mgmt:$10
Total Annual:$260
Cost-Effectiveness Analysis
Cost-Effectiveness Rating
EXCELLENTQALYs Gained
0.9
Outcome-Based Costs
Cost per Responder
$262.63
Cost per Remission
$273.68
Comparison vs Oral Cobalamin
Cost Difference
+$125/year
More expensive
QALY Difference
+0.10 QALYs
Better outcomes
Dominance
No dominance
Prescription Access Economics
Annual Societal Loss per Patient
$260
Cost of prescription-only barriers (visits, time, admin, price premium)
Physician Visit Cost
$300/year
Time Cost
$150/year
Travel + wait time
Insurance Admin Cost
$60/year
Prior auth, claims
Rx Price
$50/year
Potential OTC Price
$150/year
Estimated if OTC available
Early Treatment Benefit
+0.05 QALYs
From faster OTC access
Risk Assessment
Misuse Risk
LOWMissed Diagnosis Risk
LOWRequires Monitoring
YesNeeds lab work/checkups
Intramuscular Cobalamin (Cyanocobalamin/Hydroxocobalamin) Outcomes
for Vitamin B12 Deficiency
Efficacy Outcomes
Overall Effectiveness
+99%
Response Rate
+99%
Remission Rate
+95%
Common Side Effects
Injection site pain/redness/swelling
+15%
Itching, mild diarrhea
+3%
Allergic reactions (anaphylaxis)
+0.05%
Sources:
Active Clinical Trials
2 active trials recruiting for Intramuscular Cobalamin (Cyanocobalamin/Hydroxocobalamin) in Vitamin B12 Deficiency
Early Infant Micronutrition and Development
NCT05005897RECRUITINGPHASE2, PHASE3
600 participants
INTERVENTIONAL
Lillehammer, Norway
Started: Dec 8, 2021
A Study to See if a Combination of Vitamins That is Injected Into a Muscle is as Good and Safe as a Vitamin That is Taken by Mouth
NCT07029698RECRUITINGPHASE4
46 participants
INTERVENTIONAL
Kharkiv, Ukraine +1 more
Started: Apr 16, 2025
Completed Clinical Trials
7 completed trials for Intramuscular Cobalamin (Cyanocobalamin/Hydroxocobalamin) in Vitamin B12 Deficiency
Oral/Intramuscular B12 to Treat Cobalamin Deficiency
NCT01476007COMPLETEDNA
284 participants
INTERVENTIONAL
Madrid, Spain
Started: Jul 1, 2014
Impact of Vitamin B12 Replacement on Epogen Dosing and Improvement of Quality of Life in Hemodialysis Patients
NCT01876732COMPLETEDNA
132 participants
INTERVENTIONAL
Staten Island, United States
Started: Jun 1, 2009
Cobalamin Status in Young Children With Developmental Delay
NCT00710138COMPLETEDNA
100 participants
INTERVENTIONAL
Bergen, Norway
Started: Jun 1, 2008
Cobalamin Status in Young Children With Gastrointestinal Symptoms or Feeding Problems
NCT00710359COMPLETEDNA
100 participants
INTERVENTIONAL
Bergen, Norway
Started: Apr 1, 2008
Cobalamin Supplementation During Infancy; Effect on B-vitamin Status, Growth and Psychomotor Development
NCT00479479COMPLETEDNA
107 participants
INTERVENTIONAL
Bergen, Norway
Started: Dec 1, 2004
Vitamin B12 Acceptance and Biomarker Response Study
NCT01832129COMPLETEDPHASE4
37 participants
INTERVENTIONAL
Basel, Switzerland
Started: May 1, 2013
Megadose of Hydroxocobalamin for the Treatment of Pernicious Anemia
NCT03372447COMPLETEDPHASE4
13 participants
INTERVENTIONAL
Monterrey, Mexico
Started: Dec 27, 2017