시아노코발라민 (비타민 B12)
Cyanocobalamin (Vitamin B12)
Cyanocobalamin
다른 이름: Cyanoject · Rubesol · Crysti · Crystamine · Amtech Vitamin B12 · Anivit B12 · Cobalaplex · Cyanocobalamin PXN-B12 · Neo-Cytamen · Vitbee · cobalamins · cyanocobalamine · cyanocobalaminum · cobamin · cianokobalaminas · cianocobalamina · cycobemin · Hydroxocobalamin
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Cobalamin deficiency in dogs with severe GI disease (protein losing enteropathies, inflammatory bowel disease) | 25 micrograms/kg | SC/IM | once per week for 4-6 weeks, then once monthly thereafter | Lifelong therapy may be required | 🌎 NA |
| Cobalamin deficiency associated with GI disease | 250-1200 micrograms (total dose) | SC | once weekly for 6 weeks, then every 14 days for 6 weeks, then one dose 30 days later | Initial 16-week protocol | 🌎 NA |
| Cobalamin deficiency associated with exocrine pancreatic insufficiency | 250-500 mcg (total dose) | parenterally | repeat treatment based upon serum levels | — | 🌎 NA |
- Cobalamin deficiency in dogs with severe GI disease (protein losing enteropathies, inflammatory bowel disease): May take as long as 3-4 weeks to see a response.
- Cobalamin deficiency associated with GI disease: Based on body size. Recheck serum cobalamin concentration one month after last dose. If normal, continue at least monthly. If subnormal, continue weekly or bi-weekly.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Cobalamin deficiency in cats with IBD | 250-500 micrograms (total dose per cat) | SC | once per week for 6 weeks, then every 1-2 months | — | 🌎 NA |
| Adjunctive treatment of idiopathic hepatic lipidosis | 250 micrograms (total dose) | SC | once per week | 6 weeks | 🌎 NA |
| Cobalamin deficiency associated with GI disease | 150-250 micrograms (total dose) | SC | once weekly for 6 weeks, then every 14 days for 6 weeks, then one dose 30 days later | Initial 16-week protocol | 🌎 NA |
| Cobalamin deficiency associated with exocrine pancreatic insufficiency | 100-250 micrograms (total dose) | SC | once weekly | — | 🌎 NA |
- Adjunctive treatment of idiopathic hepatic lipidosis: Recheck serum B12 level in one to two weeks after cessation of treatment as some cats may need repeated administration.
- Cobalamin deficiency associated with GI disease: Based on body size. Recheck serum cobalamin concentration one month after last dose.
- Cobalamin deficiency associated with exocrine pancreatic insufficiency: Periodically assess cobalamin and folate levels.
말
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Vitamin B12 deficiency | 1-2 mL of a 1000 micrograms/mL injection (1000-2000 micrograms per horse) | IM or SC | once or twice weekly | — | 🌎 NA |
- Vitamin B12 deficiency: Dosage may be repeated as indicated by condition or response.
소
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Treatment of vitamin B12 deficiency associated with cobalt deficiency | 0.2-0.4 mL of a 5000 micrograms/mL injection (1000-2000 micrograms) | IM or SC | weekly intervals if necessary | — | 🌎 NA |
돼지
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Vitamin B12 deficiency | 0.1-0.4 mL of a 5000 micro-grams/mL injection (500-2000 micrograms) | IM or SC | weekly intervals if necessary | — | 🌎 NA |
양
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Treatment of vitamin B12 deficiency associated with cobalt deficiency (Lambs) | 100 micrograms (total dose) | injection | once weekly | — | 🌎 NA |
| Treatment of vitamin B12 deficiency associated with cobalt deficiency (Adult sheep) | 300 micrograms (total dose) | injection | once weekly | — | 🌎 NA |
| Treatment of vitamin B12 deficiency associated with cobalt deficiency | 0.2-0.4 mL of a 5000 micrograms/mL injection (1000-2000 micrograms) | IM or SC | weekly intervals if necessary | — | 🌎 NA |
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
시아노코발라민(비타민 B12)은 정상적인 세포 기능에 필수적인 수용성 비타민입니다.
- 주요 용도: 비타민 B12 결핍증의 주사 치료.
- 결핍의 주요 원인: 외분비 췌장 기능 부전(EPI), 염증성 장질환(IBD) 및 기타 흡수 불량성 위장관 질환.
- 종 특이성:
- 개와 고양이: 위장관/췌장 질환에 속발하는 결핍증이 흔합니다. 자이언트 슈나우저 등의 품종은 유전적 흡수 장애(이머슬룬드-그라스베크 증후군)를 가질 수 있습니다.
- 반추동물: 반추위 미생물이 B12를 합성하기 위해 코발트를 필요로 하므로 식이성 코발트 결핍에 속발하는 경우가 많습니다.
임상 요점: 사람과 달리 개와 고양이는 TC1 결합 단백질이 없기 때문에 흡수 불량 상태에서 1
2개월 만에 B12 저장량이 빠르게 고갈될 수 있습니다(사람은 12년 소요).
작용 기전
Vitamin B12 acts as a crucial coenzyme for two major enzymatic pathways:
- Methylmalonyl-CoA mutase: Converts methylmalonyl-CoA → succinyl-CoA. (Deficiency leads to methylmalonic acidemia/aciduria).
- Methionine synthase: Catalyzes the remethylation of homocysteine → methionine, which is intimately linked with folate metabolism.
- Required for normal cell growth, nucleoprotein and myelin synthesis, amino acid metabolism, and erythropoiesis.
- Note: B12 deficiency can cause a functional folate deficiency. Unlike humans, macrocytic anemias do not appear to be a significant component of cobalamin deficiency in dogs or cats.
안전성·주의사항
금기사항
- Hypersensitivity to cyanocobalamin or hydroxocobalamin
- Known hypersensitivity to cobalt or cobalamin
부작용
- Pain at injection site (uncommon)
- Anaphylaxis (rarely reported in humans)
- Pain or stinging at the injection site
- Mild allergic reactions (rare)
주의
Safe to use during pregnancy and nursing. Serum samples to be analyzed for cobalamin and/or folate should be protected from bright light and excessive heat.
약물 상호작용
Concurrent use can cause falsely low serum or red blood cell cobalamin values if a microbiologic method assay is used.
May decrease oral absorption of Vitamin B12 by altering gastric pH
모니터링
- Serum cobalamin levels
- Serum folate status (both before and after treatment)
- Clinical signs associated with deficiency (weight loss, poor haircoat, vomiting, diarrhea)
- CBC (baseline and ongoing if abnormal)
- Serum cobalamin (Vitamin B12) levels
- Serum folate levels
- Clinical signs of gastrointestinal disease (weight gain, fecal consistency)
약동학
반감기
흡수
Cobalamin in food binds to haptocorrin in the stomach → degraded by pancreatic proteases in the duodenum → binds to Intrinsic Factor (IF) (produced in stomach/pancreas in dogs, pancreas only in cats) → absorbed in the small intestine via cubulin → enters portal circulation.
분포
Binds to transcobalamin 2 (TCII) for entry into target cells. Dogs and cats lack cobalamin-binding protein TC1, leading to rapid depletion of stores (1-2 months) compared to humans (1-2 years).
대사
Undergoes entero-hepatic recirculation.
배설
Rapidly excreted into the bile.
과다투여
Cyanocobalamin is very safe. An inadvertent overdose given via SC or IM injection is unlikely to cause significant morbidity.
제품
제형
- Injection
- Oral tablets (human-labeled, not recommended for small animal deficiency states)
- Injectable: 0.25 mg/ml solution
- Injectable: 1 mg/ml solution
- Oral: 0.5 mg capsule
동물용의약품
- Cyanocobalamin (Vitamin B12) Injection 1000 micrograms/mL
- Cyanocobalamin (Vitamin B12) Injection 3000 micrograms/mL
- Cyanocobalamin (Vitamin B12) Injection 5000 micrograms/mL
- Anivit B12 250
- Anivit B12 1000
- Cobalaplex
- Cyanocobalamin PXN-B12
- Vitbee 250
- Vitbee 1000
인용의약품
- Cyanocobalamin Injection 100 micrograms/mL
- Cyanocobalamin Injection 1000 micrograms/mL
- Oral tablets (not recommended for small animal deficiency states)
- Neo-Cytamen (hydroxocobalamin)
규제 현황
Classified as POM-VPS in the UK.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Store below 40°C; protect from light and freezing. Cyanocobalamin injection is reportedly compatible with all commonly used intravenous fluids.
보호자 정보
- 인내가 필요합니다: B12 치료를 시작한 후 반려동물의 상태(예: 체중 증가, 대변 상태 개선)가 눈에 띄게 호전되기까지 몇 주가 걸릴 수 있습니다.
- 장기적인 관리: 기저 질환(만성 위장 문제 또는 EPI 등)에 따라 반려동물은 평생 비타민 B12 보충이 필요할 수 있습니다.
- 가정 내 투여: 이 약물은 피하 주사로 투여되므로, 수의사가 집에서 안전하게 주사하는 방법을 알려줄 수 있습니다.
중요: 집에서 주사를 투여하더라도 B12 수치가 적절히 유지되는지 확인하기 위해 정기적인 후속 진료와 혈액 검사가 필수적입니다.
VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.