• Methylcobalamin is well transported to nerve cell organelles, and promotes nucleic acid and protein synthesis: Еxperiments in rats show that methylcobalamin is better transported to nerve cell organelles than cyancobalamin and promotes nucleic acid and protein synthesis more than cobamamide does. Experiments with cells from the brain origin and spinal nerve cells in rats also show methylcobalamin to be involved in the synthesis of thymidine from deoxyuridine, promotion of deposited folic acid utilization and metabolism of nucleic acid.
• Methylcobalamin promotes axonal transport and axonal regeneration. In rat models with streptozotocin-induced diabetes mellitus, methylcobalamin normalizes axonal skeletal protein transport in sciatic nerve cells. Methylcobalamin exhibits neuropathologically and electrophysiologically inhibitory effects on nerve degeneration in neuropathies induced by drugs, such as adriamycin, acrylamide, and vincristine (in rats and rabbits), models of axonal degeneration in mice and neuropathies in rats with spontaneous diabetes mellitus.
• Methylcobalamin promotes myelination (phospholipidsynthesis): Methylcobalamin promotes the synthesis of lecithin which is the main constituent of medullary sheath lipid. It also increases myelination of neurons in rat tissue culture more than cobamamide does.
• Methylcobalamin restores delayed synaptic transmission and diminished neurotransmitters back to normal: Methylcobalamin restores end-plate potential induction early by increasing nerve fiber excitability in the crushed sciatic nerve in rats. In addition, methylcobalamin normalizes diminished levels of acetylcholine in brain tissue of rats fed with a choline-deficient diet.

Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.

Adult Dosage

The usual adult dosage for oral use is 1 tablets (1,500 µg of methylcobalamin) daily. The dosage may be adjusted depending on the patient’s age and symptoms.

Mode of administration: Oral.

Other medicines and Tolmin

Absorption of vitamin B12 from the gastrointestinal tract may be reduced by neomycin, aminosalicylic acid, histamine H2-antagonists, omeprazole, and colchicine. Serum concentrations may be decreased by use of oral contraceptives. Many of these interactions are unlikely to be of clinical significance but should be taken into account when performing assays for blood concentrations.

Like all medicines, this medicine can cause side effects, although not everybody gets them.

• Dermatologic Effects: Rash ; In the event of such symptoms, treatment should be discontinued.
• Gastrointestinal Effects: Anorexia, nausea/vomiting and diarrhea
• Neurologic Effects (Central nervous system): Headache
• Others:
  • Anaphylactoid reaction: decrease in blood pressure or dyspnea, may occur. Patients should be carefully observed. In the event of such symptoms, treatment should be discontinued immediately and appropriate measures taken.
  • Hot sensation
  • Diaphoresis

In addition, your doctor may identify changes in your blood or urine test results

Warnings and precautions

This product should not be used aimlessly for more than one month unless it is effective. Vitamin B12 should, if possible, not be given to patients with suspected vitamin B12 deficiency without first confirming the diagnosis. Where it is desirable to start therapy immediately, combined treatment for both deficiencies may be started once suitable samples have been taken to permit diagnosis of the deficiency, and the patient converted to the appropriate treatment once the cause of the anaemia is known. Regular monitoring of the blood is advisable. Although the haematological symptoms of B12 deficiency and folate deficiency are similar, it is important to distinguish between them since the use of folate alone in B12-deficient megaloblastic anaemia can improve haematological symptoms without preventing aggravation of accompanying neurological symptoms, and may lead to severe nervous system sequelae such as subacute combined degeneration of the spinal cord. Use of doses greater than 10 micrograms daily may produce a haematological response in patients with folate deficiency and indiscriminate use may mask the precise diagnosis. Conversely, folate may mask vitamin B12 deficiency.

Precautions concerning use:

Administration: Methylcobalamin is susceptible to photolysis. Light decreases the content of methylcobalamin and tablets may change colour with exposure to moisture. Therefore, this product should be used promptly after the package is opened, and caution should be taken so as not to expose the tablets to light/moisture.

Pregnancy and Lactation

Pregnancy

There are no data available for methylcobalamin to be used in pregnant women.

Lactation

There are no data available for methylcobalamin to be used in lactating women. However, since vitamin B12 is distributed into breast milk, The American Academy of Pediatrics considers its use to be usually compatible with breast feeding. Ask your doctor or pharmacist for advice before taking any medicine.