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Rubramin PC (Cyanocobalamin) - Summary



Cyanocobalamin Injection USP

Rubramin PC (Cyanocobalamin Injection) contains cyanocobalamin (vitamin B12) in a clear, red, sterile, nonpyrogenic, aqueous solution in a potency of 1000 mcg/mL (cobalt: 40 mcg/mL) for intramuscular use. Each mL of solution also contains 10 mg benzyl alcohol as a preservative and sodium chloride for isotonicity; pH has been adjusted between 4.5 and 7.0 with sodium hydroxide or hydrochloric acid. Cyanocobalamin is very hygroscopic in the anhydrous form, and sparingly soluble in water (1:80). The vitamin B12 coenzymes are very unstable in light.

Rubramin PC is indicated for use as the flushing dose in the Schilling (vitamin B12 absorption) Test for pernicious anemia.

See all Rubramin PC indications & dosage >>


Media Articles Related to Rubramin PC (Cyanocobalamin)

New diagnostic tools for dehydration severity in children
Source: GastroIntestinal / Gastroenterology News From Medical News Today [2015.08.21]
System may improve intake of cholera, diarrhea casesDehydration from diarrhea, either from viral infection or cholera, accounts for 10 percent of all child deaths worldwide.

Novel diagnostic tool for ethnically diverse non-small-cell lung cancer patients
Source: Lung Cancer News From Medical News Today [2015.08.17]
A new serum miRNA panel could lead to accurately and early diagnosing NSCLC in ethnically diverse patientsEarly-stage Non-small-cell Lung Cancer (NSCLC) is asymptomatic and difficult to detect...

Diagnostic imaging can rule out coronary artery disease in patients with atypical chest pain
Source: Radiology / Nuclear Medicine News From Medical News Today [2015.08.13]
Non-invasive diagnostic imaging can rule out coronary artery disease (CAD) in about 50% of women with atypical chest pain who are at relatively low risk for CAD, while exposing them to only a modest...

Delay in treatment, missed diagnostic testing found among lung cancer patients
Source: Lung Cancer News From Medical News Today [2015.08.06]
Study published in The Annals of Thoracic Surgery examines how long it takes to begin care and what steps are taken to determine appropriate treatmentPatients undergoing surgery for lung cancer...

Study identifies delays in lung cancer treatment due to missed diagnostic testing
Source: Lung Cancer News From Medical News Today [2015.07.31]
Many patients with suspected lung cancer are missing diagnostic tests, which is leading to delays in treatment for the condition, according to new research.

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Published Studies Related to Rubramin PC (Cyanocobalamin)

Folic acid, pyridoxine, and cyanocobalamin combination treatment and age-related macular degeneration in women: the Women's Antioxidant and Folic Acid Cardiovascular Study. [2009.02.23]
BACKGROUND: Observational epidemiologic studies indicate a direct association between homocysteine concentration in the blood and the risk of age-related macular degeneration (AMD), but randomized trial data to examine the effect of therapy to lower homocysteine levels in AMD are lacking. Our objective was to examine the incidence of AMD in a trial of combined folic acid, pyridoxine hydrochloride (vitamin B(6)), and cyanocobalamin (vitamin B(12)) therapy... CONCLUSIONS: These randomized trial data from a large cohort of women at high risk of cardiovascular disease indicate that daily supplementation with folic acid, pyridoxine, and cyanocobalamin may reduce the risk of AMD.

Comparative effects of hydroxocobalamin and cyanocobalamin on plasma homocysteine concentrations in end-stage renal disease. [2005.10]
End-stage renal disease (ESRD) is associated with marked hyperhomocysteinemia which is only partially corrected by folic acid and pyridoxine supplementation. We and others have reported that various forms of parenteral cobalamin reduce plasma total homocysteine (tHcy) concentrations of patients with ESRD substantially below the lowest levels attainable with folic acid...

Oral cyanocobalamin supplementation in older people with vitamin B12 deficiency: a dose-finding trial. [2005.05.23]
BACKGROUND: Supplementation with high doses of oral cobalamin is as effective as cobalamin administered by intramuscular injection to correct plasma markers of vitamin B(12) deficiency, but the effects of lower oral doses of cobalamin on such markers are uncertain... CONCLUSION: The lowest dose of oral cyanocobalamin required to normalize mild vitamin B(12) deficiency is more than 200 times greater than the recommended dietary allowance, which is approximately 3 mug daily.

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Clinical Trials Related to Rubramin PC (Cyanocobalamin)

Plasma Holotranscobalamin as Compared to Plasma Cobalamins for Assessment of Vitamin B12 Absorption [Completed]
In the present study the design of the vitamin B12 absorption test, CobaSorb, is further optimised. We investigate which test – measurement of holotranscobalamin or cobalamins – could be used for reflection of vitamin B12 absorption. Furthermore, we prolong the duration of vitamin B12 administration in order to determine the final duration of the vitamin B12 absorption test CobaSorb.

Seventy-eight healthy individuals (age 21-81 years) are treated with three oral doses of 9 microgram cyanocobalamin per day for five successive days. Non-fasting blood samples are collected on day 1-5 before administration of the first dose of vitamin B12 and on day 8. Cobalamins and holotranscobalamin are measured on day 1–5 and 8. The performance of the vitamin B12 absorption test will be evaluated in individuals with borderline or low levels of holotranscobalamin or cobalamins (below the 75% percentiles) using a change larger than 2CV(day to day) of holotranscobalamin (22%) and cobalamins (12%) to indicate a change caused by absorption of the administered vitamin B12.

How Many Patients Are in Need of Vitamin B12 Injections? [Recruiting]
The clinical consequences of vitamin B12 deficiency include megaloblastic anemia and neurological disorders. Therefore, a proper and timely diagnosis and treatment is important. The use of sensitive biochemical markers such as methylmalonic acid for the diagnosis of vitamin B12 deficiency have increased since the 1980s. Consequently, the number of individuals treated with vitamin B12 has increased significantly.

The objective of this project is to study the actual need for vitamin B12 injections in the group of individuals who have already started treatment. In order to investigate this, the investigators stop vitamin B12 treatment in this group, and look for signs of vitamin B12 deficiency by monitoring changes in biochemical and hematological markers. Furthermore, they will test if the individuals are able to absorb a physiological dose of vitamin B12 using a recently developed absorption test (CobaSorb). If a physiological dose can be absorbed, the vitamin B12 injections can be replaced with tablets. In the end, the investigators hope to be able to divide the patients into three groups:

1. need life long injections with vitamin B12,

2. only need supplementations with a small dose of oral vitamin B12, and

3. no need for further vitamin B12 treatment.

The perspective is that the new information from this study might be used for a future strategy for vitamin B12 treatment.

Can Recombinant Human Intrinsic Factor Be Used for Evaluation of the Vitamin B12 Absorption? [Completed]
Vitamin B12 is an essential nutrient for normal DNA-synthesis and must be supplied by animal products. Vitamin B12 deficiency may cause anemia and irreverible neurological damage. Laboratory tests are used for diagnosis of vitamin B12 deficiency, and following the diagnosis, the cause of the vitamin B12 deficiency has to be clarified. For years a test called Shilling’s test has been used for evaluation of the vitamin B12 absorption. However, the Schilling’s test is no longer easy accessible because of increasing difficulties to obtain the radioactively labeled vitamin B12 requested, and native human intrinsic factor for Schilling’s test II (absorption of vitamin B12 attached to intrinsic factor) is no longer available in most countries. Recently, human intrinsic factor unsaturated with vitamin B12 has been expressed in the plant Arabidopsis thaliana. The purpose of this study was to examine whether recombinant human intrinsic factor is able to promote the uptake of vitamin B12 in patients with evident vitamin B12 deficiency.

Oral Vitamin B12 Supplementation and Cognitive Performance in Elderly People [Completed]
The purpose of this trial is to study the effects of oral vitamin B12 supplementation and vitamin B12 combined with folic acid supplementation on cognitive performance for 24 weeks in elderly people with mild vitamin B12 deficiency.

Evaluation of Holotranscobalamin as an Indicator of Vitamin B12 Absorption [Recruiting]
Vitamin B12 is an essential nutrient that the body needs for cells to divide and function normally. Individuals may develop a deficiency of vitamin B12 by either limiting the amount in the diet or by decreased vitamin B12 intake into the body (absorption). Keeping adequate B12 blood levels is important for health. Vitamin B12 deficiency may increase one's risk for developing anemia and can even lead to neurological problems and paralysis if the deficiency is severe and lasts a long time. It is very important for doctors to have accurate tests to determine if people are absorbing vitamin B12 normally so that treatment can be started before severe clinical problems occur.

The purpose of this research is to provide new information that may help scientists develop a better method to test for problems with absorbing vitamin B12. In this study, changes in the amounts of vitamin B12 bound to protein (transcobalamin) in the blood will be measured after doses of vitamin B12 are taken. If the amounts of this vitamin B12-protein complex (called holo-transcobalamin) change in response to taking a vitamin B12 supplement in normal individuals, it may be possible to use this information to develop a new sensitive test to identify individuals who have problems absorbing vitamin B12. This new vitamin B12 absorption test may be a better clinical test for vitamin B12 absorption than those now available for doctors to use.

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Page last updated: 2015-08-21

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