Summary: Injectable form of VITAMIN B 12 that has been used therapeutically to treat VITAMIN B 12 DEFICIENCY.

Top Publications

  1. van der Kuy P, Merkus F, Lohman J, ter Berg J, Hooymans P. Hydroxocobalamin, a nitric oxide scavenger, in the prophylaxis of migraine: an open, pilot study. Cephalalgia. 2002;22:513-9 pubmed
    ..In the underlying pilot study the prophylactic effect of the NO scavenger hydroxocobalamin after intranasal administration in migraine was evaluated...
  2. DesLauriers C, Burda A, Wahl M. Hydroxocobalamin as a cyanide antidote. Am J Ther. 2006;13:161-5 pubmed
  3. Fortin J, Giocanti J, Ruttimann M, Kowalski J. Prehospital administration of hydroxocobalamin for smoke inhalation-associated cyanide poisoning: 8 years of experience in the Paris Fire Brigade. Clin Toxicol (Phila). 2006;44 Suppl 1:37-44 pubmed
    This article reports the results of a retrospective study of 8 years of experience of the Paris Fire Brigade with the prehospital use of hydroxocobalamin.
  4. Uhl W, Nolting A, Golor G, Rost K, Kovar A. Safety of hydroxocobalamin in healthy volunteers in a randomized, placebo-controlled study. Clin Toxicol (Phila). 2006;44 Suppl 1:17-28 pubmed
    This randomized, double-blind, placebo-controlled, ascending-dose study was conducted in healthy volunteers to evaluate the safety of the investigational cyanide antidote hydroxocobalamin.
  5. Borron S, Stonerook M, Reid F. Efficacy of hydroxocobalamin for the treatment of acute cyanide poisoning in adult beagle dogs. Clin Toxicol (Phila). 2006;44 Suppl 1:5-15 pubmed
    The efficacy of hydroxocobalamin for acute cyanide poisoning was compared with that of saline vehicle in dogs. Anesthetized adult beagle dogs were administered potassium cyanide (0.4 mg/kg/min, IV) until 3 min after the onset of apnea...
  6. Hall A, Dart R, Bogdan G. Sodium thiosulfate or hydroxocobalamin for the empiric treatment of cyanide poisoning?. Ann Emerg Med. 2007;49:806-13 pubmed
    ..Among several cyanide antidotes available, sodium thiosulfate and hydroxocobalamin have been proposed for use in these circumstances...
  7. Lee J, Mukai D, Kreuter K, Mahon S, Tromberg B, Brenner M. Potential interference by hydroxocobalamin on cooximetry hemoglobin measurements during cyanide and smoke inhalation treatments. Ann Emerg Med. 2007;49:802-5 pubmed
    Concentrated aqueous solutions of hydroxocobalamin (OHCob) are administered intravenously for cyanide poisoning victims, many of whom also have concurrent smoke inhalation...
  8. Hoffer L, Djahangirian O, Bourgouin P, Eid J, Saboohi F. Comparative effects of hydroxocobalamin and cyanocobalamin on plasma homocysteine concentrations in end-stage renal disease. Metabolism. 2005;54:1362-7 pubmed
    ..16-week randomized controlled crossover trial which directly compared the Hcy-lowering effect of intravenous hydroxocobalamin (HC) with that of cyanocobalamin (CC)...
  9. Borron S, Baud F, Barriot P, Imbert M, Bismuth C. Prospective study of hydroxocobalamin for acute cyanide poisoning in smoke inhalation. Ann Emerg Med. 2007;49:794-801, 801.e1-2 pubmed
    To assess outcomes in patients treated with hydroxocobalamin at the fire scene or in the ICU for suspected smoke inhalation-associated cyanide poisoning.

More Information


  1. Zheng D, Yan L, Birke R. Electrochemical and spectral studies of the reactions of aquocobalamin with nitric oxide and nitrite ion. Inorg Chem. 2002;41:2548-55 pubmed
    ..These results can be used to explain a number of physiological effects involving NO interaction in biological systems with added cobalamin or with cobalamin in the methionine synthase enzyme. ..
  2. Bebarta V, Tanen D, Lairet J, Dixon P, Valtier S, Bush A. Hydroxocobalamin and sodium thiosulfate versus sodium nitrite and sodium thiosulfate in the treatment of acute cyanide toxicity in a swine (Sus scrofa) model. Ann Emerg Med. 2010;55:345-51 pubmed publisher
    Cyanide can cause severe hypotension with acute toxicity. To our knowledge, no study has directly compared hydroxocobalamin and sodium nitrite with sodium thiosulfate in an acute cyanide toxicity model...
  3. Borron S, Baud F, Megarbane B, Bismuth C. Hydroxocobalamin for severe acute cyanide poisoning by ingestion or inhalation. Am J Emerg Med. 2007;25:551-8 pubmed
    This chart review was undertaken to assess efficacy and safety of hydroxocobalamin for acute cyanide poisoning...
  4. Shepherd G, Velez L. Role of hydroxocobalamin in acute cyanide poisoning. Ann Pharmacother. 2008;42:661-9 pubmed publisher
    To review the recently approved cyanide antidote, hydroxocobalamin, and describe its role in therapy...
  5. Pamidi P, DeAbreu M, Kim D, Mansouri S. Hydroxocobalamin and cyanocobalamin interference on co-oximetry based hemoglobin measurements. Clin Chim Acta. 2009;401:63-7 pubmed publisher
    b>Hydroxocobalamin (OHCbl) and cyanocobalamin (CNCbl) are dark-red colored analogs of vitamin B-12. OHCbl is used as an alternate antidote for cyanide poisoning...
  6. van den Berg M, Merkus P, Romeijn S, Verhoef J, Merkus F. Hydroxocobalamin uptake into the cerebrospinal fluid after nasal and intravenous delivery in rats and humans. J Drug Target. 2003;11:325-31 pubmed
    The possibility of direct transport of hydroxocobalamin from the nasal cavity into the cerebrospinal fluid (CSF) after nasal administration in rats was investigated and the results were compared with a human study...
  7. Fortin J, Waroux S, Giocanti J, Capellier G, Ruttimann M, Kowalski J. Hydroxocobalamin for poisoning caused by ingestion of potassium cyanide: a case study. J Emerg Med. 2010;39:320-4 pubmed publisher
    b>Hydroxocobalamin, a precursor of vitamin B12, has a history of use in the prehospital setting in France for cyanide poisoning, particularly that associated with smoke inhalation...
  8. Erdman A. Is hydroxocobalamin safe and effective for smoke inhalation? Searching for guidance in the haze. Ann Emerg Med. 2007;49:814-6 pubmed
  9. Jeong J, Ha T, Kim J. Protection of aquo/hydroxocobalamin from reduced glutathione by a B12 trafficking chaperone. BMB Rep. 2011;44:170-5 pubmed publisher
    ..and adenosylcobalamin (AdoCbl) in the base-off states and eliminated the upper axial ligands forming aquo/hydroxocobalamin (OH(2)/OHCbl) under aerobic conditions. A transition of OH(2)/OHCbl was induced upon binding to bCblC...
  10. Mukherjee R, Brasch N. Mechanistic studies on the reaction between cob(II)alamin and peroxynitrite: evidence for a dual role for cob(II)alamin as a scavenger of peroxynitrous acid and nitrogen dioxide. Chemistry. 2011;17:11805-12 pubmed publisher
    ..Given that protein-bound Cbl is accessible to small molecules, it is likely that enzyme-bound and free intracellular Cbl(II) molecules are rapidly oxidized to inactive Cbl(III) upon exposure to peroxynitrite or (.)NO(2)...
  11. Wolak M, Stochel G, van Eldik R. Mechanistic studies on the interaction of reduced cobalamin (vitamin B12r) with nitroprusside. J Am Chem Soc. 2003;125:1334-51 pubmed
    ..The results obtained in the present study are discussed in reference to the possible influence of cobalamin on the pharmacological action of nitroprusside. ..
  12. Gaby A. Intravenous nutrient therapy: the "Myers' cocktail". Altern Med Rev. 2002;7:389-403 pubmed
    ..This paper presents a rationale for the therapeutic use of intravenous nutrients, reviews the relevant published clinical research, describes the author's clinical experiences, and discusses potential side effects and precautions. ..
  13. Smith S, Kinney H, Swoboda K, Levy H. Subacute combined degeneration of the spinal cord in cblC disorder despite treatment with B12. Mol Genet Metab. 2006;88:138-45 pubmed
    ..This is especially important now that the presymptomatic detection of cblC disorder is possible through the expansion of newborn screening. ..
  14. Chen S, Hung C, Yang C, Lo F, Hsu H. Coexistence of megaloblastic anemia and iron deficiency anemia in a young woman with chronic lymphocytic thyroiditis. Int J Hematol. 2006;84:238-41 pubmed
    ..After intramuscular injections of hydroxycobalamine 100 microg daily for 10 days, and monthly later, her blood counts returned to normal. ..
  15. Jiménez Varo I, Bueno Delgado M, Dios Fuentes E, Delgado Pecellin C, González Meneses A, Soto Moreno A, et al. [Combined methylmalonic acidemia and homocystinuria; a case report]. Nutr Hosp. 2015;31:1885-8 pubmed publisher
  16. Kozlowski P, Garabato B, Lodowski P, Jaworska M. Photolytic properties of cobalamins: a theoretical perspective. Dalton Trans. 2016;45:4457-70 pubmed publisher
    ..MeCbl) and adenosylcobalamin (AdoCbl), as well as two non-alkyl cobalamins, cyanocobalamin (CNCbl) and hydroxocobalamin (HOCbl)...
  17. Chan A, Balasubramanian M, Blackledge W, Mohammad O, Alvarez L, Boss G, et al. Cobinamide is superior to other treatments in a mouse model of cyanide poisoning. Clin Toxicol (Phila). 2010;48:709-17 pubmed publisher
    ..We found Cbi more effective than hydroxocobalamin, sodium thiosulfate, sodium nitrite, and the combination of sodium thiosulfate-sodium nitrite in treating ..
  18. Bebarta V, Pitotti R, Dixon P, Valtier S, Esquivel L, Bush A, et al. Hydroxocobalamin and epinephrine both improve survival in a swine model of cyanide-induced cardiac arrest. Ann Emerg Med. 2012;60:415-22 pubmed publisher
    To determine whether hydroxocobalamin will improve survival compared with epinephrine and saline solution controls in a model of cyanide-induced cardiac arrest...
  19. Garcia I, Rosas T, Bejarano E, Gotor C, Romero L. Transient transcriptional regulation of the CYS-C1 gene and cyanide accumulation upon pathogen infection in the plant immune response. Plant Physiol. 2013;162:2015-27 pubmed publisher
  20. Yamagiwa T, Inokuchi S, Saito T, Inoue S, Morita S, Kawaguchi A. A stable in vitro method for assessing the toxicity of potassium cyanide and its antidote. Tokai J Exp Clin Med. 2013;38:114-22 pubmed
    ..Hydrogen cyanide possesses a high acid-dissociation constant of 9.14, favoring its vaporization and depletion from the culture media at physiological pH, which may cause the cyanide toxicity unstable in vitro...
  21. Clark J, Green C, Motterlini R. Involvement of the heme oxygenase-carbon monoxide pathway in keratinocyte proliferation. Biochem Biophys Res Commun. 1997;241:215-20 pubmed
    ..abolished by co-incubation of SNP with tin protoporphyrin IX, a potent inhibitor of heme oxygenase, or hydroxocobalamin, a NO scavenger...
  22. Heyworth Smith D, Hogan P. Allergy to hydroxycobalamin, with tolerance of cyanocobalamin. Med J Aust. 2002;177:162-3 pubmed
  23. Beck R, Anes J, Savini L, Mateer R. Picomolar quantitation of free sulfite in foods by means of [57Co]hydroxocobalamin and radiometric chromatography of [57Co]sulfitocobalamin. Method, applications and significance of coexisting sulfides. J Chromatogr A. 2000;881:345-56 pubmed
    The concentration dependent reaction of sulfite with 57Co-labeled hydroxocobalamin (OH57CoCbl) to produce a sulfitocobalamin (SO(3)57CoCbl) adduct served as a quantification strategy for foodborne sulfite residues freely extracted into pH ..
  24. Burton R, Kelion Z, Costello C. Severe folate deficiency in pregnancy with normal red cell folate level. Clin Lab Haematol. 2006;28:66-8 pubmed
  25. Cisse F, Bah H, Konate F, Camara N, Camara M, Conde K, et al. [Neurological disorders related to vitamin B12 deficiency in prisons in Guinea: a 22-case study]. Bull Soc Pathol Exot. 2013;106:156-9 pubmed publisher
    ..Biermer's disease was identified in 9 patients, 3 patients showed the syndrome of non dissociation of vitamin B12, a gastrectomy in 2 patients and no etiology was identified in 8 patients. ..
  26. Iodice F, Di Chiara L, Boenzi S, Aiello C, Monti L, Cogo P, et al. Cobalamin C defect presenting with isolated pulmonary hypertension. Pediatrics. 2013;132:e248-51 pubmed publisher
    ..This novel way of presentation of cblC defect enlarges the spectrum of inherited diseases that must be considered in the differential diagnosis of pulmonary hypertension. ..
  27. Nafil H, Tazi I, Sifessalam M, Bouchtia M, Mahmal L. [Clinical, biological and therapeutic profile of anemia by vitamin B12 deficiency in the department of hematology of Marrakech (Morocco)]. Bull Soc Pathol Exot. 2013;106:83-8 pubmed publisher
    ..In patients with HP infection, eradication therapy of HP was performed. The cure rate of the HP is 90%. ..
  28. Møller S, Hemmingsen C. [Cyanide poisoning]. Ugeskr Laeger. 2003;165:2579-80 pubmed
    ..Several strategies may be employed in the treatment. Hydroxycobalamine is an effective and non-toxic antidote. On the basis of a case story, the toxicology, symptoms and treatment of cyanide poisoning are discussed. ..
  29. Brunel C, Widmer C, Augsburger M, Dussy F, Fracasso T. Antidote treatment for cyanide poisoning with hydroxocobalamin causes bright pink discolouration and chemical-analytical interferences. Forensic Sci Int. 2012;223:e10-2 pubmed publisher
    ..During resuscitation cares, she underwent an antidote treatment by hydroxocobalamin. Postmortem investigations showed marked bright pink discolouration of organs and fluids, and a lethal ..
  30. Hudson M, Cashin B, Matlock A, Kang C, Wills B. A man with purple urine. Hydroxocobalamin-induced chromaturia. Clin Toxicol (Phila). 2012;50:77 pubmed publisher
    ..Urine was collected for seven days following administration of the antidote. The drastic dark purple color of the urine on day 1, taken immediately after the antidote was given, is clearly of note. ..
  31. Froese D, Zhang J, Healy S, Gravel R. Mechanism of vitamin B12-responsiveness in cblC methylmalonic aciduria with homocystinuria. Mol Genet Metab. 2009;98:338-43 pubmed publisher
    ..While other vitamin B(12) disorders are treatable with high dose cyanocobalamin (CNCbl) or hydroxocobalamin (OHCbl), cblC patients respond well to OHCbl but not to CNCbl...
  32. Zittoun J. [Biermer's disease]. Rev Prat. 2001;51:1542-6 pubmed
    ..Pernicious anaemia should be treated indefinitely by monthly intramuscular hydroxocobalamin. Because of an increased incidence of gastric carcinoma, endoscopy should be evenly performed.
  33. Brenner M, Benavides S, Mahon S, Lee J, Yoon D, Mukai D, et al. The vitamin B12 analog cobinamide is an effective hydrogen sulfide antidote in a lethal rabbit model. Clin Toxicol (Phila). 2014;52:490-7 pubmed publisher
    ..at the time when they developed signs of severe toxicity: Group 1-saline (placebo group, N = 9); Group 2--IV hydroxocobalamin (N = 7); Group 3--IV aquohydroxocobinamide (N = 6); Group 4--IV sulfitocobinamide (N = 6); Group 5--..
  34. Tom B, De Vries R, Saxena P, Danser A. Negative inotropic effect of bradykinin in porcine isolated atrial trabeculae: role of nitric oxide. J Hypertens. 2001;19:1289-93 pubmed
    ..NO synthase inhibitor Nomega-nitro-L-arginine methyl ester (L-NAME) (100 micromol/l) and/or the NO scavenger hydroxocobalamin (200 micromol/l)...
  35. Roderique E, Gebre Giorgis A, Stewart D, Feldman M, Pozez A. Smoke inhalation injury in a pregnant patient: a literature review of the evidence and current best practices in the setting of a classic case. J Burn Care Res. 2012;33:624-33 pubmed publisher
    ..who was at 37 weeks of gestation and admitted to the Evans-Haynes Burn Center after a house fire and received hydroxocobalamin (Cyanokit) for suspected CN poisoning...
  36. Leunbach T, Johansen P, Tanner S, Gräsbeck R, Helgestad J. [Homozygous mutation in the intrinsic factor gene in a child with severe vitamin B12 deficiency]. Ugeskr Laeger. 2011;173:2047-8 pubmed
    ..Gastroscopy with biopsies showed no pathology. All were given monthly cyanocobalamin injections which, however, caused leg cramps. Replacement with monthly hydroxocobalamin was successful.
  37. Smulders Y, Smith D, Kok R, Teerlink T, Swinkels D, Stehouwer C, et al. Cellular folate vitamer distribution during and after correction of vitamin B12 deficiency: a case for the methylfolate trap. Br J Haematol. 2006;132:623-9 pubmed
    ..This is the first time that virtually all features of the methylfolate trap hypothesis have been demonstrated in a human with vitamin B12 deficiency. ..
  38. Santiago I. [Gas poisoning]. An Sist Sanit Navar. 2003;26 Suppl 1:173-80 pubmed
    ..Normo or hyperbaric oxygenotherapy is the treatment for carbon monoxide poisoning. In the case of cyanide poisoning, hydroxocobalamin is nowadays the treatment of choice, since it has proved itself to be an efficient antidote.
  39. Ouyang L, Rulis P, Ching W, Slouf M, Nardin G, Randaccio L. Electronic structure and bonding in hydroxocobalamin. Spectrochim Acta A Mol Biomol Spectrosc. 2005;61:1647-52 pubmed
    The electronic structure of hydroxocobalamin (OHCbl) has been calculated by a density functional method, using the orthogonalized linear combination of the atomic orbitals method (OLCAO)...
  40. Łopaciński B, Kołaciński Z, Winnicka R. [Sodium azide--clinical course of the poisoning and treatment]. Przegl Lek. 2007;64:326-30 pubmed
    ..The efficacy of treatment with antidotes for cyanide poisoning has not been unequivocally determined for this kind of intoxication. ..
  41. Uhl W, Nolting A, Gallemann D, Hecht S, Kovar A. Changes in blood pressure after administration of hydroxocobalamin: relationship to changes in plasma cobalamins-(III) concentrations in healthy volunteers. Clin Toxicol (Phila). 2008;46:551-9; discussion 576-7 pubmed publisher
    To assess the relationship between blood pressure changes following infusion of antidotal doses of hydroxocobalamin and plasma concentrations of total and free cobalamins-(III)...
  42. Nilsson K, Warkentin S, Hultberg B, Fäldt R, Gustafson L. Treatment of cobalamin deficiency in dementia, evaluated clinically and with cerebral blood flow measurements. Aging (Milano). 2000;12:199-207 pubmed
    ..The clinical improvement was also mirrored in general and focal rCBF changes. ..
  43. Bromley J, Hughes B, Leong D, Buckley N. Life-threatening interaction between complementary medicines: cyanide toxicity following ingestion of amygdalin and vitamin C. Ann Pharmacother. 2005;39:1566-9 pubmed
    ..The patient also ingested 4800 mg of vitamin C per day. She responded rapidly to hydroxocobalamin treatment. The adverse drug reaction was rated probable on the Naranjo probability scale...
  44. Naidu D, Ragsdale S. Characterization of a three-component vanillate O-demethylase from Moorella thermoacetica. J Bacteriol. 2001;183:3276-81 pubmed
    ..MtvB catalyzes methyl transfer from a phenylmethylether to the cobalt center of MtvC, a corrinoid protein. MtvA catalyzes transmethylation from MtvC to tetrahydrofolate, forming methyltetrahydrofolate. Cobalamin can substitute for MtvC. ..
  45. Guigonis V, Fremeaux Bacchi V, Giraudier S, Favier R, Borderie D, Massy Z, et al. Late-onset thrombocytic microangiopathy caused by cblC disease: association with a factor H mutation. Am J Kidney Dis. 2005;45:588-95 pubmed
    ..Long-term subcutaneous administration of hydroxocobalamin in combination with oral betaine and folic acid resulted in clinical and biological improvement in both ..
  46. Bryan Lluka L, Papacostas M, Paczkowski F, Wanstall J. Nitric oxide donors inhibit 5-hydroxytryptamine (5-HT) uptake by the human 5-HT transporter (SERT). Br J Pharmacol. 2004;143:63-70 pubmed
    ..4 The inhibitory effects of the NO donors were not affected by the free radical scavenger, hydroxocobalamin (1 mM) or the guanylate cyclase inhibitor, ODQ (1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one; 3 microM). 5...
  47. Colpaert E, Timmermans J, Lefebvre R. Influence of antioxidant depletion on nitrergic relaxation in the pig gastric fundus. Br J Pharmacol. 2002;135:917-26 pubmed
    ..superoxide generators 6-anilino-5,8-quinolinedione (LY83583) and hydroquinone (HQ) and of the NO-scavengers hydroxocobalamin (HC) and 2-(4-carboxyphenyl)-4,4,5,5-tetramethylimidazoline-1-oxyl-3-oxide (c-PTIO) to affect nitrergic ..
  48. Nafil H, Tazi I, Mahmal L. [Biermer's disease and autoimmune hemolytic anemia]. Ann Biol Clin (Paris). 2012;70:480-2 pubmed
    ..Despite its association with several autoimmune disorders, few observations have reported an association with autoimmune hemolytic anemia (AIHA). We report a case of Biermer's disease associated with AIHA in a patient of 66 years old. ..
  49. Kohl R, Lacey C, Homick J. An appraisal of the value of vitamin B12 in the prevention of motion sickness. Acta Astronaut. 1983;10:219-24 pubmed
    ..Hematological parameters revealed no B12 deficiency before injection. The possibility that patients with B12 deficiencies are more susceptible to motion sickness cannot be ruled out. ..
  50. Ellis A, Lu H, Li C, Rand M. Effects of agents that inactivate free radical NO (NO*) on nitroxyl anion-mediated relaxations, and on the detection of NO* released from the nitroxyl anion donor Angeli's salt. Br J Pharmacol. 2001;134:521-8 pubmed
    1. The effects of agents that inactivate free radical nitric oxide (carboxy-PTIO, hydroxocobalamin and pyrogallol) were tested on relaxations produced by the nitroxyl anion (NO(-)) donor Angeli's salt in rat aortic rings and anococcygeus ..
  51. Borron S, Arias J, Bauer C, Sanchez M, Fernandez M, Jung I. Hemodynamics after intraosseous administration of hydroxocobalamin or normal saline in a goat model. Am J Emerg Med. 2009;27:1065-71 pubmed publisher
    b>Hydroxocobalamin may be lifesaving in cyanide (CN) poisoning, but personal protective equipment (PPE) wear, rescue, and decontamination may delay intravenous administration...
  52. Koschel M. Management of the cyanide-poisoned patient. J Emerg Nurs. 2006;32:S19-26 pubmed
  53. De Bie I, Nizard S, Mitchell G. Fetal dilated cardiomyopathy: an unsuspected presentation of methylmalonic aciduria and hyperhomocystinuria, cblC type. Prenat Diagn. 2009;29:266-70 pubmed publisher
    ..Inborn errors of metabolism should be considered in the investigation of prenatally diagnosed dilated cardiomyopathy in view of the possible impact on treatment and future reproductive options, in some of these conditions. ..