Pharmacy Guide
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Pharmacy Guide
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Cyanokit 5g powder for solution for infusion
⚠ This medicine appears to have been discontinued
The electronic medicines compendium (emc) no longer publishes a Summary of Product Characteristics for this product, which usually means it is no longer marketed in the UK. The patient leaflet below is kept for reference, but the product may not be available.
If you were prescribed this medicine, other products containing Hydroxocobalamin may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.
What it is and what it is used for
for
Cyanokit contains the active substance hydroxocobalamin. Cyanokit is an antidote for the treatment of known or suspected cyanide poisoning in all age ranges. Cyanokit is to be administered together with appropriate decontamination and supportive measures. Cyanide is a highly poisonous chemical. Cyanide poisoning may be caused by exposure to smoke from household and industrial fires, breathing or swallowing cyanide, or contact with cyanide on skin.
2.
What you need to know before Cyanokit is used
Warnings and precautions Tell your doctor or other health care professional if you are allergic to hydroxocobalamin or vitamin B12. They will have to take it into account before treating you with Cyanokit. that you have been treated with Cyanokit if you need to have the following:
- any blood or urine tests. Cyanokit may modify the results of these tests.
- burn assessment. Cyanokit may interfere with the assessment as it causes red coloration of the skin.
- haemodialysis. Cyanokit may lead to shut down of haemodialysis machines until it is eliminated from the blood (at least 5.5 to 6.5 days).
- monitoring of renal function: Cyanokit may lead to kidney failure and urine crystals. Other medicines and Cyanokit Tell your doctor or other health care professional if you are taking, have recently taken or might take any other medicines. Detailed information for your doctor or other health care professional regarding simultaneous administration of Cyanokit with other medicines can be found at the end of this package leaflet (see 'Handling instructions'). 1
Pregnancy and breast-feeding This medicine is an emergency treatment. It can be administered during pregnancy and breast-feeding. Tell your doctor as soon as possible if you were pregnant or think you may have been pregnant during treatment with Cyanokit. Your doctor will recommend you to stop breast-feeding after treatment with Cyanokit.
3.
How to take it
Your doctor or health care professional will give you Cyanokit by infusion into a vein. You may need one or two infusions. You will have the first infusion of Cyanokit over 15 minutes. For adults, the initial dose is 5 g. For children, it is 70 mg/kg body weight, up to a maximum dose of 5 g. If you need a second infusion, you will have it over 15 minutes to 2 hours. It depends on how serious the poisoning is. The maximum total recommended dose is 10 g for adults, and 140 mg/kg in children up to a maximum of 10 g. Detailed instructions for your doctor or other health care professional on how to prepare the Cyanokit infusion and how to determine the dose can be found at the end of this package leaflet (see 'Handling instructions'). If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
4.
Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them. The following side effects may be expected (frequency cannot be estimated from the available data): Allergy (hypersensitivity) Tell your doctor immediately if you have the following symptoms during or after this treatment: swelling around the eyes, lips, tongue, throat or hands breathing difficulties, hoarseness, difficulty in speaking skin redness, nettle rash (urticaria) or itching. Such side effects may be serious and need immediate attention. Heart and blood pressure problems
symptoms such as headache or dizziness, as they may be due to a rise in blood pressure. This rise in blood pressure especially occurs at the end of having this treatment and usually settles down within several hours irregular heart beat redness of the face (flush). A decrease in blood pressure and a faster heart beat have also been observed in patients who have cyanide poisoning. Breathing and chest problems
fluid in the chest (pleural effusion) breathing difficulties a feeling of tightness in the throat dry throat 2
chest pressure.
Renal and urinary problems kidney injuries such as acute kidney impairment and urine crystals. red colouration of the urine. All patients will show a dark red colouration of the urine quite marked during the first three days following administration. Urine colouration may last up to 35 days after administration of Cyanokit. This red colouration has no other consequences on your body. Gastrointestinal (digestive) problems
discomfort in your stomach indigestion diarrhoea feeling sick (nausea) being sick (vomiting) difficulty in swallowing.
Eye problems
swelling, irritation, redness.
Skin reactions
most patients will experience a reversible red colouration of the skin and membranes lining body cavities (mucous membranes) that may last up to 15 days after administration of Cyanokit. blister-like lesions on the skin (pustular rashes). These may last for several weeks, and affect mainly the face and the neck. inflammation in the part of the body where the medicine was infused.
Skin reactions
blister-like lesions on the skin (pustular rashes). These may last for several weeks, and affect mainly the face and the neck. inflammation in the part of the body where the medicine was infused.
Other side effects
restlessness problems with memory dizziness headache swelling of ankles changes in the results of blood tests for certain white blood cells (lymphocytes) coloured plasma, which may cause artificial elevation or reduction in the levels of certain laboratory parameters.
Reporting of side effects If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via Yellow Card Scheme at: www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine. 3
5.
How Cyanokit is stored
Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the vial, the cardboard box and the carton after EXP. Do not store above 25°C. For the purpose of ambulatory use, Cyanokit may be exposed during short periods to the temperature variations of usual transport (15 days submitted to temperatures ranging from 5 to 40°C) transport in the desert (4 days submitted to temperatures ranging from 5 to 60°C) and freezing/defrosting cycles (15 days submitted to temperatures ranging from -20 to 40°C). For storage conditions of the reconstituted medicine, see 'Handling instructions' at the end of this package leaflet. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines no longer used. These measures will help protect the environment.
6.
Contents of the pack and other information
What Cyanokit contains
The active substance is hydroxocobalamin. The vial contains 5 g of hydroxocobalamin. After reconstitution with 200 mL of diluent, each mL of the reconstituted solution contains 25 mg of hydroxocobalamin. The other ingredient is hydrochloric acid (for pH adjustment).
What Cyanokit looks like and contents of the pack Cyanokit powder for solution for infusion is a dark red crystalline powder supplied in a glass vial closed with bromobutyl rubber stopper and an aluminium cap with a plastic lid. Each pack contains one vial packed in one cardboard box, one sterile transfer device, one sterile intravenous infusion set and one sterile short catheter for administration to children. Marketing Authorisation Holder SERB S.A. Avenue Louise 480 1050 Brussels Belgium Manufacturer Merck Santé s.a.s. / SEMOY 2, rue du Pressoir Vert 45400 Semoy France This leaflet was last revised in July/2017.
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Other sources of information Detailed information on this medicine is available on the European Medicines Agency web site: http://www.ema.europa.eu. ————————————————————————————————————————-The following information is intended for medical or healthcare professionals only: Handling instructions Treatment of cyanide poisoning must include immediate attention to airway patency, adequacy of oxygenation and hydration, cardiovascular support, and management of seizures. Consideration must be given to decontamination measures based on the route of exposure. Cyanokit does not substitute oxygen therapy and must not delay the set up of the above measures. The presence and extent of cyanide poisoning are often initially unknown. There is no widely available, rapid, confirmatory cyanide blood test. However, if a cyanide blood level determination is planned, it is recommended to draw the blood sample before initiation of treatment with Cyanokit. Treatment decisions must be made on the basis of clinical history and/or signs and symptoms of cyanide intoxication. If there is clinical suspicion of cyanide poisoning, it is strongly recommended that Cyanokit be administered without delay. Preparation of Cyanokit The vial is to be reconstituted with 200 mL of diluent using the supplied sterile transfer device. Sodium chloride 9 mg/mL (0.9%) solution for injection is the recommended diluent. Only when sodium chloride 9 mg/mL (0.9%) solution for injection is not available, Lactated Ringer solution or glucose 50 mg/mL (5%) solution for injection can also be used. The Cyanokit vial is to be rocked or inverted for at least 1 minute to mix the solution. It must not be shaken as shaking the vial may cause foam and therefore may make checking reconstitution less easy. Because the reconstituted solution is a dark red solution, some insoluble particles may not be seen. The intravenous infusion set provided in the kit must then be used as it includes an appropriate filter and is to be primed with the reconstituted solution. Posology Initial dose Adults: The initial dose of Cyanokit is 5 g (200 mL, complete volume of reconstituted solution). Paediatric population: In infants to adolescents (0 to 18 years old), the initial dose of Cyanokit is 70 mg/kg body weight not exceeding 5 g. Body weight in kg Initial dose in g in mL
5
10
20
30
40
50
60
0.35 14
0.70 28
1.40 56
2.10 84
2.80 112
3.50 140
4.20 168
Subsequent dose Depending upon the severity of the poisoning and the clinical response, a second dose may be administered
5
Adults: The subsequent dose of Cyanokit is 5 g (200 mL, complete volume of reconstituted solution). Paediatric population: In infants to adolescents (0 to 18 years old), the subsequent dose of Cyanokit is 70 mg/kg body weight not exceeding 5 g. Maximum dose Adults: The maximum total recommended dose is 10 g. Paediatric population: In infants to adolescents (0 to 18 years old), the maximum total recommended dose is 140 mg/kg not exceeding 10 g. Renal and hepatic impairment No dose adjustment is required in these patients. Method of administration Initial dose of Cyanokit is administered as an intravenous infusion over 15 minutes. The rate of intravenous infusion for the second dose ranges from 15 minutes (for patients extremely unstable) to 2 hours based on patient condition. Simultaneous administration of Cyanokit and other products Cyanokit must not be mixed with diluents other than sodium chloride 9 mg/mL (0.9%) solution for injection or Lactated Ringer solution or glucose 50 mg/mL (5%) solution for injection. As physical and chemical incompatibilities were observed with a number of selected medicinal products that are frequently used in resuscitation efforts, these and other medicinal products must not be administered simultaneously in the same intravenous line as hydroxocobalamin. If blood products (whole blood, packed red cells, platelet concentrate and fresh frozen plasma) and hydroxocobalamin are administered simultaneously, use of separate intravenous lines (preferably on contralateral extremities) is recommended. Combination with another cyanide antidote: Chemical incompatibility was observed with sodium thiosulfate and sodium nitrite. If the decision is made to administer another cyanide antidote with Cyanokit, these medicinal products must not be administered concurrently in the same intravenous line. In-use stability of the reconstituted solution Chemical and physical in-use stability of the reconstituted solution with sodium chloride 9 mg/mL (0.9%) has been demonstrated for 6 hours at a temperature between 2°C to 40°C. From a microbiological point of view, the medicinal product should be used immediately. If not used immediately, in-use storage times and conditions prior to use are the responsibility of the user and would normally not be longer than 6 hours at 2°C to 8°C.
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Frequently asked questions about Cyanokit 5g powder for solution for infusion
How do I take Cyanokit 5g powder for solution for infusion?
Cyanokit 5g powder for solution for infusion comes as infusion containing 5g. Always follow the dose your doctor or pharmacist has given you, and read the leaflet that comes with the medicine.
What is the active substance in Cyanokit 5g powder for solution for infusion?
The active substance in Cyanokit 5g powder for solution for infusion is hydroxocobalamin.
Where does this information come from?
This leaflet reproduces the patient information leaflet approved for Cyanokit 5g powder for solution for infusion, as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.
Can I get Cyanokit 5g powder for solution for infusion without a prescription?
Whether a medicine is available over the counter or on prescription only depends on its licence. Check the leaflet, or ask your pharmacist — they can tell you straight away.
About this leaflet
The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.
- Source: electronic medicines compendium (emc), Datapharm
- Active substance: hydroxocobalamin
- Official document: view the original leaflet on emc →
⚕For healthcare professionals — Summary of Product Characteristics (SmPC)Full SmPC: dosage, interactions, contraindications, warnings+
4.1. Therapeutic indications
Treatment of known or suspected cyanide poisoning in all age ranges.
Cyanokit is to be administered together with appropriate decontamination and supportive measures (see section 4.4).
4.2. Posology and method of administration
Posology
Initial dose
Adults: The initial dose of Cyanokit is 5 g (2 x 100 mL).
Paediatric population: In infants to adolescents (0 to 18 years old), the initial dose of Cyanokit is 70 mg/kg body weight not exceeding 5 g.
Body weight in kg
5
10
20
30
40
50
60
Initial dose
in g
in mL
0.35
14
0.70
28
1.40
56
2.10
84
2.80
112
3.50
140
4.20
168
Subsequent dose
Depending upon the severity of the poisoning and the clinical response (see section 4.4), a second dose may be administered.
Adults: The subsequent dose of Cyanokit is 5 g (2 x 100 mL).
Paediatric population: In infants to adolescents (0 to 18 years old), the subsequent dose of Cyanokit is 70 mg/kg body weight not exceeding 5 g.
Maximum dose
Adults: The maximum total recommended dose is 10 g.
Paediatric population: In infants to adolescents (0 to 18 years old), the maximum total recommended dose is 140 mg/kg not exceeding 10 g.
Renal and hepatic impairment
Although the safety and efficacy of hydroxocobalamin have not been studied in renal and hepatic impairments, Cyanokit is administered as emergency therapy in an acute, life-threatening situation only and no dose adjustment is required in these patients.
Method of administration
Initial dose of Cyanokit is administered as an intravenous infusion over 15 minutes.
The rate of intravenous infusion for the second dose ranges from 15 minutes (for patients extremely unstable) to 2 hours based on patient condition.
For instructions on reconstitution of the medicinal product before administration, see section 6.6.
4.3. Contraindications
None.
4.4. Special warnings and precautions for use
Treatment of cyanide poisoning must include immediate attention to airway patency, adequacy of oxygenation and hydration, cardiovascular support, and management of seizures. Consideration must be given to decontamination measures based on the route of exposure.
Cyanokit does not substitute oxygen therapy and must not delay the set up of the above measures.
The presence and extent of cyanide poisoning are often initially unknown.
There is no widely available, rapid, confirmatory cyanide blood test.
Treatment decisions must be made on the basis of clinical history and/or signs and symptoms of cyanide intoxication.
Cyanide poisoning may result from exposure to smoke from closed space fires, inhalation, ingestion, or dermal exposure. Sources of cyanide poisoning include hydrogen cyanide and its salts, cyanogens, including cyanogenic plants, aliphatic nitriles, or prolonged exposure to sodium nitroprusside.
Signs and symptoms of cyanide poisoning
Common signs and symptoms of cyanide poisoning include: nausea, vomiting, headache, altered mental status (e.g. confusion, disorientation), chest tightness, dyspnoea, tachypnoea or hyperpnoea (early), bradypnoea or apnoea (late), hypertension (early) or hypotension (late), cardiovascular collapse, seizures or coma, mydriasis, and plasma lactate concentration > 8 mmol/L.
In the setting of multiple casualties such as terrorism or chemical disaster, panic symptoms including tachypnoea and vomiting may mimic early cyanide poisoning signs. The presence of altered mental status (confusion and disorientation) and/or mydriasis is suggestive of true cyanide poisoning.
Smoke inhalation
Not all smoke inhalation victims necessarily will have cyanide poisoning, but may present with burns, trauma, and exposure to additional toxic substances aggravating the clinical picture. Before Cyanokit is administered, it is recommended to check affected persons for the presence of the following:
• exposure to fire smoke in an enclosed area soot present around mouth, nose and/or oropharynx altered mental status
In this setting hypotension and/or a plasma lactate concentration ≥ 10 mmol/L (higher than the one mentioned under signs and symptoms due to the fact that carbon monoxide contributes to lactic acidaemia) are highly suggestive of cyanide poisoning. In the presence of the above signs, treatment with Cyanokit must not be delayed to obtain a plasma lactate concentration.
Hypersensitivity reactions
Known hypersensitivity to hydroxocobalamin or vitamin B12 must be taken into benefit-risk consideration before administration of Cyanokit, since hypersensitive reactions may occur in patients receiving hydroxocobalamin (see section 4.8).
Renal disorders
Oxalate crystals have been observed in the urine of healthy volunteers given hydroxocobalamin. Cases of acute renal failure with acute tubular necrosis, renal impairment and urine calcium oxalate crystals present have been reported in patients treated with hydroxocobalamin following known or suspected cyanide poisoning. In some situations, hemodialysis was required to achieve recovery (see section 4.8).
Therefore, as a precaution, after Cyanokit administration, regular monitoring of renal function (including blood urea nitrogen and serum creatinine) should be performed until 7 days after drug onset.
Increase in blood pressure
Transient, generally asymptomatic, increase in blood pressure may occur in patients receiving hydroxocobalamin. The maximal increase in blood pressure has been observed toward the end of infusion (see section 4.8).
Effects on blood cyanide assay
Hydroxocobalamin will lower blood cyanide concentrations. While determination of blood cyanide concentration is not required and must not delay treatment with hydroxocobalamin, it may be useful for documenting cyanide poisoning. If a cyanide blood level determination is planned, it is recommended to draw the blood sample before initiation of treatment with Cyanokit.
Interference with burn assessment
Because of its deep red colour, hydroxocobalamin has the potential to induce a red colouration of the skin and therefore may interfere with burn assessment. However, skin lesions, oedema, and pain are highly suggestive of burns.
Interference with laboratory tests
Because of its deep red colour, hydroxocobalamin has the potential to interfere with determination of laboratory parameters (e.g. clinical chemistry, haematology, coagulation, and urine parameters). In vitro tests indicate that the extent and duration of the interference is dependant on numerous factors such as the dose of hydroxocobalamin, analyte, analyte concentration, methodology, analyser, concentrations of cobalamins-(III) including cyanocobalamin and partially the time between sampling and measurement.
Based on in vitro studies and pharmacokinetic data obtained in healthy volunteers the following table describes interference with laboratory tests that may be observed following a 5 g dose of hydroxocobalamin. Interference following a 10 g dose can be expected to last up to an additional 24 hours. The extent and duration of interference in cyanide-poisoned patients may differ according to the severity of intoxication. Results may vary considerably from one analyser to another, therefore, caution is required when reporting and interpreting laboratory results.
Observed in vitro interferences of hydroxocobalamin with laboratory tests
Laboratory parameter
No interference observed
Artificially increased*
Artificially decreased*
Unpredictable***
Duration of interference after a 5 g dose
Clinical chemistry
Calcium
Sodium
Potassium
Chloride
Urea
Gamma glutamyl transferase (GGT)
Creatinine
Total and conjugate bilirubin**
Triglycerides
Cholesterol
Total protein
Glucose
Albumin
Alkaline phosphatase
Alanine aminotransferase (ALT)
Amylase
Phosphate
Uric acid
Aspartate aminotransferase (AST)
Creatine kinase (CK)
Creatine kinase isoenzym MB (CKMB)
Lactate dehydrogenase (LDH)
24 hours with the exception of bilirubin (up to 4 days)
Haematology
Erythrocytes
Haematocrit
Mean corpuscular volume (MCV)
Leucocytes
Lymphocytes
Monocytes
Eosinophils
Neutrophils
Platelets
Haemoglobin (Hb)
Mean corpuscular haemoglobin (MCH)
Mean corpuscular haemoglobin concentration (MCHC)
12-16 hours
Coagulation
Activated partial thromboplastin time (aPTT)
Prothrombin time (PT) Quick or INR
24 hours
* ≥ 10% interference observed on at least one analyser
** Artificially decreased using the diazo method
*** Inconsistent results
Analysers used: ACL Futura (Instrumentation Laboratory), Axsym/Architect (Abbott), BM Coasys110 (Boehringer Mannheim), CellDyn 3700 (Abbott), Clinitek 500 (Bayer), Cobas Integra 700, 400 (Roche), Gen-S Coultronics, Hitachi 917, STA® Compact, Vitros 950 (Ortho Diagnostics)
Hydroxocobalamin may interfere with all urine colorimetric parameters. The effects on these tests typically last 48 hours after a 5 g dose, but may persist for longer periods. Caution is required in the interpretation of urinary colorimetric tests for as long as chromaturia is present.
Interference with haemodialysis
Because of its deep red color, hydroxocobalamin may cause haemodialysis machines to shut down due to an erroneous detection of a 'blood leak'. This should be considered before haemodialysis is initiated in patients treated with hydroxocobalamin.
Use with other cyanide antidotes
The safety of administering other cyanide antidotes simultaneously with Cyanokit has not been established (see section 6.2). If the decision is made to administer another cyanide antidote with Cyanokit, these medicinal products must not be administered concurrently in the same intravenous line (see section 6.2).
4.5. Interaction with other medicinal products and other forms of interaction
No interaction studies have been performed.
4.6. Fertility, pregnancy and lactation
Pregnancy
Animal studies have shown teratogenic effects following daily exposure throughout organogenesis (see section 5.3). There are no adequate data from the use of hydroxocobalamin in pregnant women and the potential risk for humans is unknown. However, taken into account:
- that no more than two injections of hydroxocobalamin are to be administered,
- the potentially life threatening condition,
- the lack of alternative treatment, hydroxocobalamin may be given to a pregnant woman.
In case of known pregnancy at the time of treatment with Cyanokit or in case that pregnancy becomes known after treatment with Cyanokit, health care professionals are requested to promptly report the exposure during pregnancy to the Marketing Authorisation Holder and/or Health Authorities and to carefully follow-up on the pregnancy and its outcome.
Breast-feeding
Because hydroxocobalamin will be administered in potentially life-threatening situations, breast-feeding is not a contraindication to its use. In the absence of data in breast-fed infants, breast-feeding discontinuation is recommended after receiving Cyanokit.
Fertility
No studies on fertility have been performed (see section 5.3).
4.7. Effects on ability to drive and use machines
Not relevant.
4.8. Undesirable effects
Summary of the safety profile
A total of 347 subjects were exposed to hydroxocobalamin in clinical studies. Of these 347 subjects, 245 patients had suspected exposure to cyanide at the time of hydroxocobalamin administration. The remaining 102 subjects were healthy volunteers who had not been exposed to cyanide at the time of hydroxocobalamin administration.
List of adverse reactions
The following adverse reactions have been reported in association with Cyanokit use. However, because of the limitations of the available data, it is not possible to apply frequency estimations:
Blood and lymphatic system disorders
Decrease in the percentage of lymphocytes.
Immune system disorders
Allergic reactions including angioneurotic oedema, skin eruption, urticaria and pruritus.
Psychiatric disorders
Restlessness.
Nervous system disorders
Memory impairment; dizziness.
Eye disorders
Swelling, irritation, redness.
Cardiac disorders
Ventricular extrasystoles. An increase in heart rate was observed in cyanide-poisoned patients.
Vascular disorders
Transient increase in blood pressure, usually resolving within several hours; hot flush. A decrease in blood pressure was observed in cyanide-poisoned patients.
Respiratory, thoracic and mediastinal disorders
Pleural effusion, dyspnoea, throat tightness, dry throat, chest discomfort.
Gastrointestinal disorders
Abdominal discomfort, dyspepsia, diarrhoea, vomiting, nausea, dysphagia.
Skin and subcutaneous tissue disorders
Reversible red colouration of the skin and mucous membranes : most patients will experience it up to 15 days after administration of Cyanokit.
Pustular rashes, which may last for several weeks, affecting mainly the face and the neck.
Renal and urinary disorders
• Acute renal failure with acute tubular necrosis, renal impairment, urine calcium oxalate crystals present (see section 4.4).
• Chromaturia : all patients will show a dark red colouration of the urine quite marked during the first three days following administration. Urine colouration may last up to 35 days after administration of Cyanokit (see section 4.4 ).
General disorders and administration site conditions
Headache; injection site reaction; peripheral oedema.
Investigations
Cyanokit may cause red discolouration of the plasma, which may cause artificial elevation or reduction in the levels of certain laboratory parameters (see section 4.4).
Paediatric population
Limited data on children (0 to 18 years old) treated with hydroxocobalamin did not show any difference in the safety profile of hydroxocobalamin between adults and children.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via Yellow Card Scheme Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
4.9. Overdose
Doses as high as 15 g have been administered without reported specific dose related adverse reactions. If overdose occurs, treatment is directed to the management of symptoms. Haemodialysis may be effective in such a circumstance, but is only indicated in the event of significant hydroxocobalamin-related toxicity. However, hydroxocobalamin because of its deep red colour may interfere with the performance of haemodialysis machines (see section 4.4).
🇵🇱 Known in Poland as
Medicines sold in Poland with the same active substance: W Polsce znany jako
- CyanokitHydroxocobalaminum · injection / infusion
Same active substance. The strength, the form and whether you need a prescription can differ. Always ask a pharmacist before you switch. Polish medicines in the UK →
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Ask anything about Cyanokit 5g powder for solution for infusion. The assistant answers only from this leaflet — if the leaflet does not cover it, it will say so. It does not give medical advice.
Answers come from the patient leaflet published on the electronic medicines compendium (emc). They are not medical advice. Ask a pharmacist or your GP if you are unsure. For urgent help call NHS 111, or 999 in an emergency.