Before Using

Drug information provided by: IBM Micromedex

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:


Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.


Appropriate studies have not been performed on the relationship of age to the effects of cyanocobalamin nasal spray in the pediatric population. Safety and efficacy have not been established.


Although appropriate studies on the relationship of age to the effects of cyanocobalamin nasal spray have not been performed in the geriatric population, no geriatric-specific problems have been documented to date.


Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Chloramphenicol

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Allergic rhinitis or hay fever (unexplained runny nose or sneezing) or
  • Nasal congestion (stuffy nose) or
  • Upper respiratory tract infection (eg, chills, fever, difficulty breathing)—Cyanocobalamin may not be effective when used in patients with these conditions.
  • Allergy to cobalt—Should not be used in patients with this condition.
  • Bone marrow problems or
  • Folic acid deficiency or
  • Iron deficiency—Use with caution. May make these conditions worse.
  • Leber's disease (genetic eye disease)—Use is not recommended in patients with this condition.
  • Megaloblastic anemia, severe—May increase risk for hypokalemia (low potassium level in the blood) or thrombocytosis (excess number of platelets in the blood).
  • Polycythemia vera (bone marrow disorder)—Using this medicine may mask or hide the signs of polycythemia vera.