Hydroxocobalamin in the USA

[ClareP5]

Hi, could you DM me if you know how or where to get it in the USA - asking for my sister who needs B12 shots. Thanks in advance

[pvanderaa]

Happy New Year !!

It will be cyano-B12. You need a prescription from a GP or specialist or an Urgent Care. Just about any pharmacy has it or can get it in a few days. You’ll need medical insurance to get a decent price (i.e. $9 for 4x 1000 ml vials with rubber stoppers) but I have also paid out of pocket (i.e. approximately $100) for extras on occasion when I’m traveling.

For the standard prescription, Hydroxo-B12 is typically injected every 3 months in the UK. Whereas cyano-B12 is injected monthly here in the USA.

When I lived in the UK, I was able to convince my GP that I needed hydroxo-B12 monthly and here in the USA I get 1000 mgc/ml of cyano-B12 weekly.

I’ve tried cyano, methyl (500 mcg/ml) and hydroxo injections at different points in the past 16 years, typically of a weekly basis. All work the same for me and the only difference is how long they last before running out between injections. For me that duration is also dependent on my level of stress.

The pharmacy also will dispense syringes for the injections. To take up the B12 into the syringe, clean the rubber stopper with alcohol wipes (swabs), also available in the pharmacy, and inject the needle through the rubber stopper, no need to try remove the rubber stopper. Hold the vial and syringes upside down (needle up) and slowly withdraw the needle while pulling back the plunger to get every last drop of B12.

I get my sublinguals at Costco. You’ll need a friend with a membership for this. Qty 300 5000 mgc tablets of methyl for around $19 OTC.

You can also find B12 sublinguals OTC in pharmacies and health food stores but it will be cyano.

thanks,

Paul

[wedgewood]

I don’t actually know where you can get B12 for injection in the USA ,nwithout a prescription, but I do know that your fellow countrymen get it without any problems from Canadian online pharmacies . It is prescription -free there ,

The Canadian sites only supply Cynocobalamin which is the usual B12 injectable used in the USA .

biosenseclinic.com. Have single use ampoules ( safest method) and multi-use vials .

Also. canadadrugsuperstore.com. have the same

buy-otc.com. also

[B12life]

as others said, only by script or Germany.

Germany will be expensive.

I have been doing the cyano because it is easier to get. I get that from the .canadadrugsuperstore.com

that wedgewood mentioned.

[Bloggin]

I am in the US & have been getting my methylcobalamin from a website called perniciousanemia.org lots of good information on the site as well. You can also buy the injectable saline on the site. Let me know if you have questions.

[mcg-woo]

Hello, the only way to obtain B12 injections in the US without an Rx is at a lab that administers them or a healthcare facility such as Patient First. I personally have only obtained them through a private lab that will also run tests without doctor’s orders. This was when I couldn’t obtain adequate injections from my doctor so I took matters into my own hands. I got better and my doctor agreed to increased dosing.

I obtain 30ml hydroxocobalamin vials from Walgreens with an Rx from my doctor. In the US, this version of B12 must be injected intramuscularly as directed by the manufacturer, Actavis. I started out on cyanocobalamin but switched over after receiving hydroxo from that private clinic. I inject weekly which is very aggressive dosing in the US, but it is what keeps me in remission. I couldn’t get better on injections every two weeks but I also never had loading doses.

Just do a google search and see if you can find a lab or clinic in your area that administers b12 injections. I think I paid about $75 for a package that included 5 injections and I got one weekly. The lab I used is about 60 miles south of Washington, DC. Best of luck.

[Motheroflittle]

In the USA its by prescription only and will be cyanocobalamin. Its $8 a vial at Walmart pharmacy for me in S.C. with the GoodRX card. Which is a free discount pharmacy card for the non- insured. You can sign up for one online and they mail it to you. Most pharmacy's carry B12 vials but you need a prescription. I wanted a backup supply of B12 so I ordered from amazon.de. I could get hydrox or cyano shipped to my home quite inexpensively without a prescription. I had no issues getting it. I use 1000ml cyano every other week.

Nice of you to help your sister. Hope you find what she needs.

[MoKayD]

You should just go ahead and buy the cyano B12. Take it from me, it works great. Tell your sister to ask her doctor for a prescription then you can pick it from your local pharmacy. I have also ordered B12 from Biosense in Canada which I keep in a drawer as back up in case I need it.

[scnuke]

Depending on your injection frequency, you have a few options. You can order Cyano from Canada without Rx in 10 or 30ml or single use vials. You can ask your physician for an Rx for either Cyano or Hydroxo and get it filled at most any pharmacy. You can get single (1ml) or multidose vials. If you inject frequently enough to justify buying multidose, remember that the vials are only good for no more than 30 days after the first withdrawal. You can also get Methyl from specialty pharmacys or find it online. Online, it comes as a powder and has to be mixed. Unless you are medically trained or have experience with sterile procedures, I do not recommend this. I have used Methyl and found it to be very expensive and no more effective than either Cyano or Hydroxo. I get 30ml vials of Hydroxo from my local Walgreens with my Rx and it costs about $21 with the GoodRx discount card. Good luck.

[B12life]

When I do order hydroxo, I get it from here as they ship to US.

apotheke-marienbrunn.de

[EiCa in reply to B12life]

I am in the US and have successfully ordered from apotheke-marienbrunn.de 3 times now. I recently tried Amazon.de and waited a long time to hear "not available". I used to get individual syringes of hydroxycobalamin with a prescription (1mg/1ml) from a compounding pharmacist but it was very expensive and they expired in one month and I had to drive a couple hours to fill it. However, if you are lucky enough to have a doctor who uses a compounding pharmacy, hydroxy is easily ordered in 30 ml. vials from all over the country. I think getting pre-filled individual syringes is pretty unusual but for some reason this one pharmacy does it that way. Probably more profitable.

[Runner623 in reply to EiCa]

Hi EiCa,

I’m in the US, Arizona. This is what I’ve discovered over that past couple of years. The FDA has certain requirements for how B12 is compounded. Each state may vary a bit, but is roughly the same. FDA requires that it be made in a compounding clean room. I get methylcobalamin. It lasts 3 days in the fridge and 45 days in a freezer. It used to come with 8 shots per bottle/vial.

Just this past year, rules changed and they are now required to only have 2 shots per bottle/vial. This pharmacy will fedex all over the state but not outside. It ships frozen overnight.

Interesting point, they are not allowed to ship pre-filled syringes unless it’s a subcutaneous needle-which is useless for most of us.

Before I found this pharmacy, I would get it from a compounding pharmacy in California. They were able to send a bottle for about 30 shots that would have a shelf life of 90 days and not kept in the fridge. Rules changed in CA over a year ago and they now follow the same rules as my current pharmacy. Both required a script.

I am curious why rules keep changing. My pharmacist said they have changed a few times for how b12 is made just in the past few years. Are there more of us with PA? Are doctors becoming more aware? I’d like to think they are but I’m not sure…

[EiCa in reply to Runner623]

Thanks Runner. I haven’t filled at my compounder for over a year now but he was my “back-up” plan. I wonder if the rules have changed here. I guess I will find out. My shots were dispensed as sub-cutaneous. My Pan Pharma is too. Why do you say it is useless?

[Runner623 in reply to EiCa]

Hi,

Most people with PA need to inject into the muscle. Subcutaneous is just under the skin. I tried it as if I didn’t get a shot at all. Many people on this forum have had the same experience. Every book I’ve read says the same.

If your b12 deficiency is not PA then subcutaneous is fine as well as a pill or sublingual.

I’ve not got it all figured out but I’ve been on a straight upward curve for nearly 3 years and think I’m now on the right path. I feel as if I’m a walking Petri dish!

Wishing you well.

[EiCa in reply to Runner623]

I am not sure I have been sufficiently tested to know if I am PA or not. I do know that my MMA and homocysteine went down from 2.5 times high range to normal (MMA) and nearly normal the last time these tests were done so I think the sub-cutaneous must be working. That said, I wonder if I should try intra-muscular to see if I have a different/better response. Pills/sublinguals/oil etc. didn't work. I have digestive problems that make injections a must. Good to hear about an upward curve.

[Rexz]

I get my Methylcobalamin in pre-loaded SC syringes shipped to me from Hopewell pharmacy in New Jersey. Makes things much easier as I do not have to mess with loading syringes myself. Just pop the cap and inject. Here's their link

hopewellrx.com/

I've been using them for two years now and they are very attentive.

You will need a prescription though.

Also note that Methylcobalamin (my preferred choice of B12) is more sensative to Cyno or Hydroxo. You will need to store it in the refrigerator and keep out of light. I just keep them in the Styrofoam shipping container in the frig. When I travel I have a small cool box that's TSA approved that was designed for insulin users.

Best of luck!

[Runner623]

clareP5,

If she lives in the California area she can contact McGuff Compounding Pharmacy. Since FDA rules changed I don’t know if they ship outside California.

If she lives in Arizona she can contact Potters Apothecary. This is where I get mine. They are wonderful to work with. They do not ship outside Arizona.

Wishing her luck.