Cyanocobalamin (Tonogen) is a man-made form of Cyanocobalamin (Tonogen). Cyanocobalamin (Tonogen) is important for growth, cell reproduction, blood formation, and protein and tissue synthesis. Cyanocobalamin (Tonogen) nasal (for use in the nose) is used to treat Cyanocobalamin (Tonogen) deficiency in people with pernicious anemia and other conditions. Cyanocobalamin (Tonogen) nasal is usually given after treatment with an injection form of this medicine. Cyanocobalamin (Tonogen) nasal may also be used for purposes not listed in Cyanocobalamin (Tonogen) guide.
Cyanocobalamin (Tonogen) side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have signs of low potassium--confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling. Common side effects may include:
runny nose, sneezing;
stuffy nose, sinus pain, sore throat, cough with mucus;
headache, dizziness;
joint pain; or
itching or rash.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. See also: Side effects (in more detail)
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Cyanocobalamin (Tonogen) dosing
Usual Adult Dose for Pernicious Anemia:
Parenteral: Initial dose: 100 mcg intramuscularly once a day for 7 days. If there is clinical improvement and a reticulocyte response, 100 mcg intramuscularly once every other day for 7 days, then once every 3 to 4 days for another 2 to 3 weeks is recommended. Most patients require monthly injections of 100 to 1000 mcg intramuscularly for life. Nasal Spray or Gel: Alternatively, Cyanocobalamin (Nascobal) nasal spray or nasal gel 500 mcg intranasally to one nostril once a week may be administered to patients with pernicious anemia who require maintenance of normal hematologic status following intramuscular Cyanocobalamin (Tonogen) and who have no nervous system involvement. However, if the patient is not adequately maintained with Cyanocobalamin (Tonogen) nasal, intramuscular Cyanocobalamin (Tonogen) administration must be resumed.
Usual Adult Dose for B12 Nutritional Deficiency:
Oral: 25 to 250 mcg once a day. Nasal Spray or Gel: (Nascobal) 500 mcg intranasally in one nostril once a week (CaloMist) 25 mcg in each nostril once a day (total dose 50 mcg). May be increased to 50 mcg in each nostril once a day.
Usual Adult Dose for Schilling Test:
1 mcg radiolabeled Cyanocobalamin orally once after urinary voiding. A 24-hour urinary collection is immediately begun. At 2 hours an injection of Cyanocobalamin (Tonogen) 1,000 mcg intramuscularly is given to "flush" the patient of absorbed radiolabeled drug. The percentage of radiolabeled B12 excreted in the urine is a measure of how much labeled drug was absorbed. Normally 7% or more of a dose is excreted in 24 hours (< 7% may be considered a positive Schilling test).
Usual Pediatric Dose for Pernicious Anemia:
Neonates and Infants: Intramuscular or Subcutaneous: 0.2 mcg/kg for 2 days, followed by 1000 mcg/day for 2 to 7 days; maintenance: 100 mcg/month. Children: Intramuscular or Subcutaneous: 30 to 50 mcg/day for 2 or more weeks (to a total dose of 1000 mcg), then follow with 100 mcg/month.
Usual Pediatric Dose for B12 Nutritional Deficiency:
Intramuscular or Subcutaneous: Initial: 0.2 mcg/kg for 2 days followed by 1000 mcg/day for 2 to 7 days followed by 100 mcg/week for a month or 100 mcg/day for 10 to 15 days, then once or twice weekly for several months. May taper to 60 mcg every month. For malabsorptive causes of B12 deficiency, monthly maintenance doses of 100 mcg have been recommended.
Can Tonogen be stopped immediately or do I have to stop the consumption gradually to ween off?
In some cases, it always advisable to stop the intake of some medicines gradually because of the rebound effect of the medicine.
It's wise to get in touch with your doctor as a professional advice is needed in this case regarding your health, medications and further recommendation to give you a stable health condition.
What other drugs will affect Cyanocobalamin (Tonogen)?
Other drugs may interact with Cyanocobalamin (Tonogen) nasal, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.
Who should not take Cyanocobalamin (Tonogen)?
You should not use this medicine if you are allergic to Cyanocobalamin (Tonogen) or cobalt, or if you have Leber's disease (an inherited form of vision loss). Cyanocobalamin (Tonogen) can lead to optic nerve damage (and possibly blindness) in people with Leber's disease.
To make sure Cyanocobalamin (Tonogen) nasal is safe for you, tell your doctor if you have:
cold or allergy symptoms that affect your nose (sinus congestion, sneezing);
kidney or liver disease;
iron or folic acid deficiency;
any type of infection; or
if you are receiving any medication or treatment that affects bone marrow.
FDA pregnancy category C. It is not known whether Cyanocobalamin (Tonogen) nasal will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.
Cyanocobalamin (Tonogen) nasal can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
Do not give this medication to anyone under 18 years old without medical advice.
How should I take Cyanocobalamin (Tonogen)?
Cyanocobalamin (Tonogen) nasal is usually given once per week. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.
This medicine comes with patient instructions for safe and effective use, and directions for priming the nasal spray. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.
To use the nasal spray:
Blow your nose gently. Keep your head upright and insert the tip of bottle into one nostril. Press your other nostril closed with your finger. Spray the medicine into your nose and gently sniff at the same time. Then use the spray in your other nostril.
Do not blow your nose for at least a few minutes after using the nasal spray.
Wait several hours after using Cyanocobalamin (Tonogen) nasal spray before using any other nasal medicines your doctor has prescribed.
Clean the tip of the spray with a clean tissue and recap.
Tell your doctor if you have a prolonged illness that causes sinus congestion. Cyanocobalamin (Tonogen) nasal may not work as well if you have a stuffy nose.
Your dose needs may change if you become pregnant, if you breast-feed, or if you eat a vegetarian diet. Tell your doctor about any changes in your diet or medical condition.
While using Cyanocobalamin (Tonogen) nasal, you may need blood tests every 3 to 6 months. Based on the results of these tests, your doctor may occasionally change your dose or recommend a Cyanocobalamin (Tonogen) injection.
Use Cyanocobalamin (Tonogen) nasal regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
To treat pernicious anemia, you may have to use Cyanocobalamin (Tonogen) for the rest of your life. Do not stop using the medicine unless your doctor tells you to. Untreated Cyanocobalamin (Tonogen) deficiency can lead to a recurrence of anemia and irreversible nerve damage.
Pernicious anemia is also treated with folic acid to help maintain red blood cells. However, folic acid will not treat Cyanocobalamin (Tonogen) deficiency and will not prevent possible damage to the spinal cord. Use all of your medications as directed.
Store in an upright position at room temperature, away from moisture, heat, and light. Do not freeze.
Can Tonogen be taken or consumed while pregnant?
Please visit your doctor for a recommendation as such case requires special attention.
Can Tonogen be taken for nursing mothers or during breastfeeding?
Kindly explain your state and condition to your doctor and seek medical advice from an expert.
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Reviews
Following the study conducted by gmedication.com on Tonogen, the result is highlighted below. However, it must be clearly stated that the survey and result is based solely on the perception and impression of visitors and users of the website as well as consumers of Tonogen. We, therefore, urge readers not to base their medical judgment strictly on the result of this study but on test/diagnosis duly conducted by a certified medical practitioners or physician.
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One patient reported time for results
How long will I use Tonogen before I begin to notice the effect? According to the report by users of gmedication.com, about 2 weeks and a few days was the most common time duration among the participants, before they began to feel relief in their health conditions. It is noteworthy that you may not get the same result with other users within the same time frame. Several factors determine the timeframe; hence we implore you to consult your medical expert to get professional advice on how long you should expect to see improvement while consuming Tonogen. However, if you wish to get the response of other users on the time effectiveness of using Tonogen kindly click here
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2 weeks
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