Hydroxocobalamin

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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

Pharmacology

  • Half-life: 26-31h
  • Metabolism: Unknown
  • Excretion: Urine

Mechanism of Action

  • 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

References