Cyanocobalamin is a manufactured form of vitamin B 12 used to treat vitamin B 12 deficiency.[2] The deficiency may occur in pernicious anemia, following surgical removal of the stomach, with fish tapeworm, or due to bowel cancer.[6] It is less preferred than hydroxocobalamin for treating vitamin B 12 deficiency.[4] It is used by mouth, by injection into a muscle, or as a nasal spray.[4][5] Cyanocobalamin is generally well tolerated.[7] Minor side effects may include diarrhea and itchiness.[8] Serious side effects may include anaphylaxis, low blood potassium, and heart failure.[8] Use is not recommended in those who are allergic to cobalt or have Leber's disease.[6] Vitamin B 12 is an essential nutrient meaning that it cannot be made by the body but is required for life.[9][7] Cyanocobalamin was first manufactured in the 1940s.[10] It is available as a generic medication and over the counter.[4][7] In 2019, it was the 155th most commonly prescribed medication in the United States, with more than 4 million prescriptions
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However, a very small percentage of B12 from a supplemental dose is absorbed by passive diffusion, rather than by intrinsic factor, such that vegans can make up for taking B12 only once per day, or even only once per week, by taking larger doses than normally provided by food
