Cyanocobalamine-Darnitsa (Vitamin В12-Darnitsa)
Vitamin В12 (cyanocobalamine and its analogues). Cyanocobalamine.
Vitamin B12 (cyanocobalamine) has a metabolic, hematopoietic effect. In the body (mainly in the liver) it turns into a coenzyme form - adenosylcobalamin, or cobamamide, which is the active form of vitamin B12. Cobamamide forms a part of many enzymes, including reductase, which reduces folic acid to tetrahydrofolic. It has high biological activity. Cobamamide is involved in the transfer of methyl and other one-carbon fragments, therefore it is necessary for the formation of deoxyribose and DNA, creatine, methionine - a donor of methyl groups, in the synthesis of lipotropic factor - choline, to convert methylmalonic acid into succinic acid, which forms part of myelin, for utilization of propionic acid. Cobamamide is essential for normal hematopoiesis because it contributes to the maturation of red blood cells. It is involved in the synthesis and accumulation in red blood cells of compounds containing sulfhydryl groups, which increases their tolerance for hemolysis. It activates the blood coagulation system, in high doses causes an increase in thromboplastic activity and prothrombin activity. It lowers blood cholesterol. It has a positive effect on the function of the liver and nervous system; increases the ability of tissues to regenerate.
Treatment of malignant, posthemorrhagic and iron deficiency anemias, aplastic anemias in children, alimentary anemias caused by toxic substances and drugs, associated with vitamin B12 deficiency, regardless of the cause of the deficiency (gastrectomy, worm infestations, violation of the process of absorption from the intestine, pregnancy). Polyneuritis, trigeminal neuralgia, radiculitis, causalgia, migraine, diabetic neuritis, amyotrophic lateral sclerosis, cerebral palsy, Down's disease, alcoholic delirium. For use in children with dystrophy, after infectious diseases, in sprue (together with folic acid), in liver diseases (hepatitis, cirrhosis, Botkin's disease), radiation sickness, psoriasis, herpetimorphic dermatitis, neurodermatitis, photodermatoses.
During the treatment, it is necessary to monitor the parameters of peripheral blood: on day 5-8 from the start of the treatment to determine the content of reticulocytes, iron concentration. The count of erythrocytes and hemoglobin, as well as the color index, should be monitored for 1 month 1-2 times a week, and then - 2-4 times a month. Remission is achieved with the increase of red blood cells to 4.0-4.5 * 1012 / l, reaching of the normal erythrocyte size, disappearance of aniso- and poikilocytosis, normalization of reticulocyte content after reticulocyte crisis. After achieving the hematological remission, peripheral blood check should be performed at least once every 4−6 months.
If there is a tendency for development of leukocytosis and erythrocytosis, the dose of the drug should be reduced or temporarily suspended.
Cyanocobalamine should not be used with drugs that increase blood clotting.
Caution should be exercised during treatment and blood clotting should be monitored in individuals with a predisposition to thrombosis and patients with angina pectoris.