Anaphylactic Reaction to Vitamin B12 Appearing after Several Years of Therapy

Ugwu, Christian; Gibbins, F. J.

doi:10.1093/ageing/10.3.196

Cited by 15 publications

(7 citation statements)

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“…Two time patterns have been found: a small proportion of reactors develop an adverse reaction immediately after administration of a sensitizing dose, 4,10 but more commonly, patients have been receiving supplementation from months to years. Such reports often point to initial minor reactions of pruritus, chest discomfort and urticaria 3,9 , 10 . In our case, negative intradermal testing to hydroxycobalamin allowed for its successful use as an alternative monthly maintenance treatment.…”

Section: Reportmentioning

confidence: 66%

“…Hypersensitivity reactions to both injectable forms of Vitamin B 12 , cyanocobalamin and hydroxycobalamin, although rare, have been described in several case reports 2–10 (Table 1). Two time patterns have been found: a small proportion of reactors develop an adverse reaction immediately after administration of a sensitizing dose, 4,10 but more commonly, patients have been receiving supplementation from months to years.…”

Section: Reportmentioning

confidence: 99%

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Type I immediate hypersensitivity reaction to cyanocobalamin but not hydroxycobalamin

et al. 2008

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We report a case of a 42-year-old woman with a background of autoimmune polyglandular syndrome, who developed a type I immediate hypersensitivity reaction to intramuscular cyanocobalamin. Intradermal testing showed a positive reaction to cyanocobalamin. The patient was subsequently treated with intramuscular hydroxycobalamin after negative intradermal testing to this alternative B(12) compound. A review of previously described cases of hypersensitivity to either compound provides a rationale for the management of this rare but serious side-effect.

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Section: Reportmentioning

confidence: 66%

Section: Reportmentioning

confidence: 99%

Type I immediate hypersensitivity reaction to cyanocobalamin but not hydroxycobalamin

et al. 2008

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“…The area under the plasma concentration-time curve from time zero to the last sampling time (AUC 0-t ) and the area under the plasma concentration-time curve from time zero to infinity (AUC 0-∞ ) were computed using the linear trapezoidal method. The plasma terminal halflife (t 1 / 2 ) and terminal elimination rate constant (k el ) were obtained from the terminal elimination phase of log 10 [concentration] as a function of time. The mean resident time (MRT) was calculated from AUMC 0-∞ /AUC 0-∞ , where AUMC 0-∞ is the area under the first-moment curve of the plasma drug concentration-time curve from time zero to infinity.…”

Section: Pharmacokinetic Analysismentioning

confidence: 99%

“…Furthermore, case reports of adverse reactions to vitamin B12 have been sporadically published in the literature. [9][10][11][12] Owing to the obvious limitations of extrapolating results from rats to humans, further preclinical and clinical evaluations are required to ensure the safety of high doses of cyanocobalamin and to confirm its PK profile.…”

Section: Figmentioning

confidence: 99%

Pharmacokinetics of high doses of cyanocobalamin administered by intravenous injection for 26 weeks in rats

Nava-Ocampo

Pastrak²,

Cruz³

et al. 2005

Clin Exp Pharma Physio

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1. High doses of vitamin B12 (cyanocobalamin) may be therapeutically effective to treat neurological alterations secondary to a wide range of disease states. The aim of the present study was to evaluate the effect of dose and repeated administration on the pharmacokinetics of cyanocobalamin in rats. 2. Forty-eight rats were randomly assigned to receive 1, 5, 25 or 100 mg/kg cyanocobalamin for 182 days (26 weeks). Cyanocobalamin plasma levels were quantified by HPLC on days 1, 85 and 182 of treatment and were analysed by means of non-compartment pharmacokinetic (PK) analysis. In addition, population PK analysis was used to fit cyanocobalamin plasma concentrations to time by means of a two-compartment model for intravascular administration. 3. The half-life of cyanocobalamin ranged from approximately 20 to 50 min, clearance ranged from 4.5 to 9 mL/min and the volume of distribution at steady state ranged from 140 to 470 mL. A statistically significant negative relationship existed between the dose of cyanocobalamin and the normalized area under the plasma concentration-time curve (AUC). This non-linearity was not exhibited in population PK analysis. No evidence of toxicity was observed. 4. At very high and prolonged doses (up to 100 mg/kg for 26 weeks), intravascular administration of cyanocobalamin in rats follows a two-compartment kinetic model and cyanocobalamin undergoes extensive extravascular distribution. The negative relationship between dose and normalized AUC is compatible with possible saturation of tubular reabsorption, thus increasing renal clearance at higher doses.

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“…Other research has shown that this vitamin may also protect against atherosclerosis through its role in homocysteine clearance. Severe hypersensitivity to vitamin B 12 injections can occur de novo after several years of treatment 58 …”

Section: Other Important Considerationsmentioning

confidence: 99%

Effects of Diet and Nutrition on Drug Therapy

Lamy¹

1982

J American Geriatrics Society

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Foods containing biochemically active substances have been used therapeutically throughout the ages and continue to function as important adjuncts to drug therapy. But naturally‐occurring substances can also have adverse effects, as can the food additives of today. Food‐drug interactions can alter the effects of therapeutic agents or cause adverse reactions where none had existed. These problems are often aggravated in elderly patients, who may suffer from malnutrition (e.g., protein insufficiency) or altered food metabolism. Malnutrition in the elderly can be caused by disease, socioeconomic factors, or simply by the deterioration of eating habits. Although nutritional requirements decrease with age, the elderly still need nutrients for the repair of normal structures and for energy. The nutritional needs of the elderly remain poorly defined. Drugs can alter food metabolism, which, in turn, can affect drug action. Many food–drug interactions are well documented; drug absorption and drug elimination are often affected by an altered food metabolism. Particular problems include salicylate‐induced iron deficiency, poor monitoring of vitamin metabolism and the effects of vitamin underuse and overuse, and lack of knowledge about the effects of long‐term drug use on vitamin metabolism. An additional problem is the presence of potentially harmful materials in non‐prescription products.

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Anaphylactic Reaction to Vitamin B12 Appearing after Several Years of Therapy

Cited by 15 publications

References 0 publications

Type I immediate hypersensitivity reaction to cyanocobalamin but not hydroxycobalamin

Type I immediate hypersensitivity reaction to cyanocobalamin but not hydroxycobalamin

Pharmacokinetics of high doses of cyanocobalamin administered by intravenous injection for 26 weeks in rats

Effects of Diet and Nutrition on Drug Therapy

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