The latest update regarding the lack of availability of Actavis/Teva 30ml hydroxocobalamin vials in the US is forcing me to look for a long term solution. The company that makes it, is now saying there’s not enough supply for regular ordering and the manufacturer will release supplies as they become available. I’ve been through shortages before over the years, but this is insane and enough is enough.
I am looking for a sterile compounding pharmacy in the US that makes hydroxocobalamin and will supply it to Virginia that also takes insurance?
Is there anyone on this forum who is sourcing injectable hydroxocobalamin through a sterile compounding pharmacy using Federal Employee Program Blue Cross Blue Shield insurance? If so, can you please point me in the right direction.? Thanks for your help in advance!
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mcg-woo
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I don't have a direct answer for you but I used to work with compounding pharmacies. Many family owned pharmacies do compounding. They may not stock the ingredients but can order them there are also mail order compounding pharmacies. Call pharmacies in your area and ask if they can compound it for you and if they take your insurance.
I am in the US and I had a compounding pharmacy compound individual injections for me. (ie: 1000mcg in 1 ml in a syringe ready to inject) Unfortunately it was quite costly and I had to drive 3 hours (round trip) to get the injections. I could only get a few at a time because they expired. I had previously used a 30ml vial a couple times but I was very uncomfortable with the risk of contamination. I then turned to getting my Pan Pharma from Germany. It isn't any picnic securing them but it solved my problem.
I did this already and what I found out is though there are lots of compounding pharmacies, it must be a sterile compounding pharmacy. I found one near where I live, but I’m only able to access methyl and the ballpark quote was over the top expensive. I’m afraid to switch to methyl since hydroxo works so well. Thanks for trying to help me.
A 30ml vial of B12 is something I'd avoid personally, as the risk of contamination is significant. Once it's been opened, however careful you are, there's a risk of contamination of the contents.
30ml vials would be more suitable for clinic use, where they're employed for treating several patients in a short space of time. However clean you think the environment is, and however scrupulous you are, the risks are just too great.
My evaluation does not lead to fear the use of multi-use vials. I do not use multi vials without a preservative for over 28 days. Diabetics have been self-injecting utilizing multi-use vials for a long period of time.
The Actavis 30ml vial is the only hydroxo option in the US and you are correct that is packaged for clinic use. Cyano is available in single use vials.
I have used a multi-use vial for about seven years with no issues and my mom is a type 1 diabetic and her insulin is only available in multi use vials—no issues her for over 50 years. Having said that, a single-use vial is clearly the preferred and safest option. If I can source hydroxo through a sterile compounding pharmacy, it would solve the multi-use vial issue. Thanks for your help and advice.
PANPHARMA ( formally Rotexmedica) 1x1ml ampoules B12 DEPOT ( Hydroxocobalamin ) Packet of 10- 1mg x 1ml ampoules
Pharmaceutical Reference number 16199653
Most popular item. Good value , but often out of stock . You can be reminded when they are back in stock by leaving your email address in the box provided .
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PASCOE B12 DEPOT packet of 10 - 1.5 mg x 1ml ampoules .Reference number 07568672.
Packets of 10 x 10 ( 100 ampoules ) Reference no. 07568695
The Pascoe are much cheaper per packet if you buy the offer of 10 packets ( 100 ampoules) If you inject weekly or more frequently , you will be covered . Other wise if you don’t inject so frequently, some ampoules may become out of date .
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HEVERT B12 DEPOT 1mg x 2ml ampoules 1 packet of 10 ampoules reference no. 06078368
It’s easier using the Pharmaceutical Reference numbers to order from the Pharmacies . But if ordering from amazon.de use the brand names . Reference numbers not accepted .
Hi Wedgewood! I did end up using some of the Pascoe, but for some reason, I feel a little different on it—mentally. I can’t figure out if I’m just being paranoid or if it’s because it’s the difference of doubling the dose of the expired Actavis 2,000 mcg versus the 1500 mcg of the Pascoe? The injection itself is comfortable, no problem.
Maybe I’m just so afraid of a relapse that I’m being paranoid? I also worry about not obtaining my b12 through a rx since not doing this may cut off my access to this route in the future? I have a positive IFAB test and diagnosis now so filling those prescriptions at the pharmacy is important. Thanks so much for trying to help me
Do you think you could use cyanocobalamin? I get it over the counter here in Canada and cost is not an issue since it only is about $1.30 per dose including the needle.
Thanks for trying to help me. I can get single use vials of cyano with an rx in the US, but hydroxo works so well for me, I’m afraid to go back to using it. Worried it might not work as well or I might need more than a weekly injection. Hydroxo put me in full remission and I don’t want to mess with a good thing! Thanks again for the reply!
I have not had any success with BCBS. Although I have not tried calling them and asking the specific question of where can I get this compounded and who is going to pay for it. I don't have the time know, but maybe in the future I will call. I would make sure if you do call to not mention you are sourcing b12 outside of the USA. I wouldn't trust the insurance companies with that information. Just me.
Thank you! Do you have the federal BCBS? It looks like there is coverage as long as the drug is not commercially available and the dosage falls within FDA approval. The 1,000 mcg shouldn’t be an issue, but the weekly frequency? Not sure on that one? I’m going to call and see what I can find out. Will keep you posted! I’m also going to call Walgreens—I’m sure they’ll just say switch to Cyano!
Thank you! Yes, I have Federal BCBS. I tried like 6+ years ago with a Pharmacy that compounds, but they only compounded Methyl-cobalamin at the time and BCBS would not cover "compounded drugs" which also included $$$ shipping; as compounding pharmacies come and go and there are none in my area. It may be different now, but back then I wasn't able to use my insurance.
Use the goodrx app and it will show sources and prices near you. Image shows hydrox 30ml vial price is really cheap with a prescription here in Arizona. Also, I have used 30ml vials for 8 years of daily injections without any issue. I load 30 syringes all at one time, then store them upright in a dark container in the fridge. Good luck!
Shows app used for searching prescription pricing.
Should have mentioned that I make the area and transfer process as sterile as possible using isopropyl alcohol in a spray bottle. Surface, hands and bottle top are sterilized well.
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Hydroxocobalamin in Germany 
Call to Panpharma
Link to German company that supplies Hydroxocobalamin injections
