Pernicious Anaemia Society
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Hydroxocobalamin IM Injection

Hello,

I received my hydroxocobalamin to inject IM. Just wanted to make sure of a couple things. I have previously been self injecting the cyanocobalamin form of B12. 1000 mcg/ml. Is the same dose okay for hyrdroxocobalamin IM? If I have been accepting the cyano form okay, I would assume as far as allergic reactions, that I should be fine with this form as well. I have read that it is very painful. I know to be slow and warm up the liquid, but is this true? Lastly, does everyone always draw back to check for placement. Could you tell if you hit an artery with the red B12? Do any of you find you need less frequent injections with the hydroxocobalamin form? I know it's a lot of questions, but any input would greatly be appreciated.

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Yes that dose is the same as 1mg which is the usual dose of B12. You will be fine with Hydroxocobalamin .I have used it for over 2 years and have never experienced any pain. at all. I inject very slowly after having used a swab on the injection area. I have never hit an artery , I once hit what must have been a vein . It gave a bit of a spurt , but never caused any trouble . I self-inject into my thighs . ( outer middle third , where the muscle is nearest the surface . ) I don’t draw back ( I don’t know what that is actually! I must have self-injected over 100 times , as I inject weekly. Never had a problem . Blood is quite different in colour and consistency to B12 . You can’t mistake one for the other . I hope this helps you a little .

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Thank you so much Wedgewood. I was a little nervous about trying something different. Your response makes me feel better. I just knew they said you should draw back to make sure you are not in the wrong place. I guess you do not want certain drugs to go directly into the vein. I tried this, but it seems a little hard to pull back, maybe if I had hit something it would flow readily back into the syringe. Thanks again for the information. I am sure it will be fine and hopefully a little better than the cyanocobalamin as far as lasting effects. I wish you the best.

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I was taught to draw back by the practice nurse during the loading dose phase and as yet I have never found it was possible. I have found using the alcohol swab at the start of getting ready for the injection is best as if I swab just before injecting the alcohol itself causes a stinging.

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Hi Sunny560 I've had over 600 cyamocobamalin 1mg B12 injections every four weeks during the past 46 years always administered by a nurse into a shoulder muscle and always at room temperature. The only time I had hydroxocobamalin was during the mid 1980s when it was introduced and I suffered an allergic reaction to it, couldn't last the three months interval between injections and so swapped back to the cyano that I'm still on today although now I have them every three weeks because of returning neuropathy in the run up to the next injection.

There is no difference in the amount of cobamalin - if it says 1mg it's the same in both.

I am not a medically trained person but I've had P.A. (a form of B12 deficiency) for more than 45 years and I'm still "clivealive" and over 75.

I wish you well

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Thanks Clivealive...I appreciate you sharing your experiences and I am so glad things have been well for you.

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My doctor said It was either cyano or raw liver three times a day :)

Even then I wasn't sure whether that was before, during, or after meals....

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Cyano or raw liver 3 times a day!! What a difficult choice clivealive. Us johnny come lately's have been very lucky.

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I might have enjoyed it fried with bacon, onions and gravy :)

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If it would have worked fried with onions and gravy clivealive then the injectable stuff would never had been developed.

And thank you for reminding me, I put some in the freezer last week, I am going to introduce a 23 year old German who is coming next weekend to the delights of lambs liver with onions and bacon - he has never had it.

On second thoughts though, 3 doses of fried onions a day, every day, would get very monotonous, and uncomfortable with the resultant 'trouser coughing'.

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Hi Sunny560

I have just started injecting myself, my third one will be this Friday.

I do it into my thigh as wedgewood suggested. I scarcely feel a thing, it is certainly not painful, not even a mild ouch. It does help that it is warm and you go in slowly. Just try and be relaxed about it.

Don't know what drawback is either, I was taught by a private GP I went to when my NHS one was difficult! He did not mention drawback.

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Thank you Beginner1. I appreciate your sharing and it makes me feel more at ease.

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There aren't any arteries running through the muscle. If you look at a piece of ham you can't see any blood vessels in there. And that's the same as your thigh.

Sometimes I get a small amount of blood leaking from the injection site. That's almost certainly because the needle has gone through a vein in the skin, on the way to the muscle.

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Thank you fbirder. I really appreciate the information.

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If your needle ends up in a vein, when you pull back on the syringe (pull back on the plunger), blood will flow into it and it will be very obvious that it is blood. If you aren't in a vein, then there is nothing to draw back, so nothing will happen. If you are injecting into an 'approved' place, then the chances of injecting into a vein are very small - I've never managed it in decades of giving injections.

Hydroxocobalamin is injected intravenously for cyanide poisoning in much higher doses than your regular jab. So although it would be far from ideal to inject it into vein, it is not something to worry unduly about.

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That’s useful to know topazrat. Thanks !

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Thank you. Very useful information.

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Hydro is fine and same dose is fine......only form I used, but that’s because I know it works. It’s not painful, I think that’s due to how invidual injects.

I’ve been injecting over a year, I never draw back as you don’t really need to. I inject in thigh....if you divide thigh from pelvic area to knee in to 4....you should inject on outer upper portion(like where you would put your right hand into a trouser pocket and where you can feel thigh).

You should be fine. Personally I think Hydroxo is more better.

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Thank you Ryaan. I really appreciate your time and the information you provided.

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