• Vitamin B ₁₂ deficiency that cannot be corrected through nutrition.
• Vitamin B ₁₂ deficiency can manifest itself in the following clinical pictures:
  • Hyperchromic macrocytic megaloblastic anemia (perniciosa, Biermer's anemia, Addison's anemia; these are disorders of the maturation of red blood cells)
  • Funicular spinal disease [spinal cord damage]
• A vitamin B ₁₂ deficiency confirmed by laboratory diagnosis can occur in:
  • Years of malnutrition and malnutrition (e.g. through a strict vegetarian diet).
  • Malabsorption (insufficient absorption of vitamin B ₁₂ in the intestine) due to,
    • insufficient production of intrinsic factor (a protein that is formed in the stomach lining and is required for the absorption of vitamin B _{12 ),}
    • Diseases in the end section of the ileum (part of the small intestine), e.g. B. Sprue,
    • Fish tapeworm infestation or
    • Blind loop syndrome (change in the course of the intestines after stomach surgery).
  • Congenital vitamin B ₁₂ transport disorders.

• At the start of treatment, 1 ml (1 ampoule) is administered once or twice a week in the first two weeks after diagnosis, corresponding to 1000 - 2000 µg cyanocobalamin per week.
• If there is evidence of a vitamin B12 _absorption disorder in the intestine, 100 µg cyanocobalamin is then administered once a month.

• The medicine is intended for long-term use.
• Please consult your doctor about this.

• Poisoning or overdose symptoms are not known.

• A double dose should not be used if the previous dose has been forgotten.

• If you interrupt the treatment, you endanger the success of the treatment! If you experience unpleasant side effects, please talk to your doctor about further treatment.

• Very common: more than 1 in 10 people treated
• Common: less than 1 in 10, but more than 1 in 100 people treated
• Uncommon: less than 1 in 100, but more than 1 in 1,000 people treated
• Rare: less than 1 in 1,000, but more than 1 in 10,000 people treated
• Very rare: less than 1 in 10,000 people treated, or unknown

• Skin symptoms (acne and eczematous and urticarial drug reactions) and hypersensitivity symptoms (anaphylactic or anaphylactoid reactions) have been observed in very rare cases.

• Please inform your doctor or pharmacist if you are taking or have recently taken any other medicines, even if they are non-prescription medicines.
• So far no interactions are known.
• Due to the instability of vitamin B ₁₂ , the vitamin can lose its effectiveness if other drugs are added.

• if you are hypersensitive (allergic) to cyanocobalamin or any of the other ingredients of the preparation.

The recommended daily vitamin B ₁₂ intake during pregnancy and breastfeeding is 4 µg. According to previous experience, higher application doses have no adverse effects on the unborn child. Vitamin B ₁₂ is excreted in breast milk.

• There are no special precautions required.