Cynomin H
Form: Injection
Strength: 1mg/ml
Generic Name: Hydroxocobalamin
Company: Jayson Pharmaceuticals Ltd.
MRP:৳ 110.0 (Injection)
Is Antibiotic: No
Indications
Cynomin H is used to treat cyanide poisoning, which can happen due to inhaling, swallowing, or skin exposure to cyanide. Sources include smoke from fires in closed spaces, cyanide salts, and certain plants. If there is a strong suspicion of cyanide poisoning, Cynomin H should be treated right away with Hydroxocobalamin.
Symptoms of cyanide poisoning may not always be clear at first. Since there isn’t a quick blood test for cyanide, treatment decisions are based on the patient’s history and symptoms. If cyanide poisoning is suspected, Hydroxocobalamin should be given immediately.
In cases of smoke inhalation, not all victims will have cyanide poisoning. Signs of cyanide poisoning include confusion, disorientation, and enlarged pupils. If there is a chance of cyanide exposure, treatment should start without waiting for lab tests.
When treating cyanide poisoning, caution should be taken when using other antidotes along with Hydroxocobalamin, as the safety of this combination is not well-known. These antidotes should not be given through the same IV line.
Pharmacology
Cynomin H is a form of Vitamin B12 where a hydroxyl group is attached to cobalt. When cyanide is present, Cynomin H can replace the hydroxyl group, forming cyanocobalamin, which is then excreted by the kidneys.
Dosage & Administration
Adults: 30 mcg daily for 5 to 10 days, followed by 100 to 200 mcg monthly by injection. If the patient is very ill or has other conditions like neurological disease or hyperthyroidism, higher doses may be needed.
Children: 1 to 5 mg over 2 or more weeks, starting with 100 mcg doses, then 30 to 50 mcg every 4 weeks for maintenance.
Interaction
Cynomin H may interact with medications like ARI Sodium Iodide, arsenic trioxide, chloramphenicol, and others. These interactions should be monitored, and the drugs should not be mixed in the same intravenous line.
Contraindications
Cynomin H should not be used in patients who are allergic to any of its components.
Side Effects
Possible side effects include mild diarrhea, itching, temporary rash, swelling, and allergic reactions. Some patients may feel pain after the injection.
Pregnancy & Lactation
Cynomin H is classified as Pregnancy Category C. Animal studies have shown risks to the fetus, but there are no human studies. Cynomin H should only be used during pregnancy if the benefits outweigh the potential risks.
Precautions & Warnings
Vitamin B12 treatment may interfere with blood tests for vitamin B12 or folic acid levels. Cynomin H should not be used as a substitute for folic acid, as Cynomin H can hide the true cause of megaloblastic anemia. Low potassium and high platelet levels may occur during treatment, so these should be monitored.
Overdose Effects
Not applicable.
Therapeutic Class
Cynomin H belongs to the class of antidotes and drugs used to treat megaloblastic anemia.
Storage Conditions
Cynomin H should be stored in a cool, dry place.