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1. What Mecobalamin injection is for Mecobalamin injection is a form of Vitamin B12, an essential vitamin which is needed for the production of red blood cells. Mecobalamin injection is used to prevent and treat certain types of anemia, including Addisonian pernicious anemia, and other kinds of anemia which result from a deficiency of Vitamin B12. It is also used for a test called the Schilling Test, which measures your ability to absorb Vitamin B12 from the bowel. 2. Before you are given Mecobalamin injection You should not be given Mecobalamin injection if: You are allergic to the active ingredient, cyanocobalamin You are allergic to any of the other ingredients of Mecobalamin injection (see section 6.) You have a condition called toxic amblyopia (poor vision which may be due to Vitamin B12 deficiency). If any of the above applies to you talk to your doctor or nurse. Check with your doctor before being given Mecobalamin injection if: You are pregnant, planning to become pregnant or breast-feeding You have megaloblastic anemia. This is a blood disorder where you have larger than normal blood cells Tell your doctor if you are taking any of the following medicines: Antibiotics (for treating infections) or antimetabolites (medicines which stop cells dividing, such as mercaptopurine for leukemia), as these treatments may interfere with tests to measure the levels of Vitamin B12 in your blood or urine An antibiotic called chloramphenicol, as you may not respond well to Mecobalamin injection Oral contraceptives ‘The Pill’ Any other medicine, including medicines obtained without a prescription. If any of the above applies to you talk to your doctor or nurse. Pregnancy and breast-feeding Mecobalamin injection should not be used in pregnancy for treating a kind of anemia called megaloblastic anemia unless you also have a Vitamin B12 deficiency. Mecobalamin injection is found in breast-milk but it is unlikely that it will harm your baby. If you are pregnant, trying to become pregnant or are breast-feeding, ask your doctor or nurse for advice before being given Mecobalamin injection. Driving and using machines Mecobalamin injection may cause dizziness. If this happens to you, do not drive or use machinery. 3. How you will be given Mecobalamin injection Important: Your doctor will choose the dose that is right for you. You will be given Mecobalamin injection by your doctor or nurse as an injection into a muscle. You may be given it just once or it may be repeated every other day, weekly or monthly, depending on how much your body needs. Adults and Children Treatment of anemia: Without neurological (nervous system) involvement: Initially, 250 ? 1000 micrograms, every other day for 1 to 2 weeks, then 250 micrograms weekly until the blood tests are normal. Maintenance dose: 1000 micrograms every month. With neurological involvement: 1000 micrograms every other day for as long as improvement is noticed. Maintenance dose: 1000 micrograms every month. Prevention of anemia: 250 -1000 micrograms every month. Schilling Test: 1000 micrograms. Medical check-ups While you are receiving this medicine, your doctor will want you to have regular blood tests to check your condition. This is to make sure that your medicine is working properly and that the dose you are receiving is right for you. If you are given more Mecobalamin injection than you should If you think you have been given too much Mecobalamin injection, you are unlikely to need any special treatment. However, if you suffer any discomfort or side effects you should tell your doctor. If you have any further questions about the use of this medicine, ask your doctor or nurse. 4. Possible side effects Like all medicines, Mecobalamin injection can cause side effects, although not everybody gets them. Stop using Mecobalamin injection and seek immediate medical help if you have an allergic reaction. This includes any of the following symptoms: Difficulties in breathing Swelling of your eyelids, face or lips Rash or itching especially those covering your whole body Collapse. Effects on the heart and blood Low blood potassium levels and irregular heartbeat during the early stages of treatment Thrombocytosis (where you have a high number of platelets in your blood) Effects on the eyes and skin Acne-like rash Blisters Pain at the site of injection The skin may become hard at the site of injection The skin around the injection site may die. Effects on the stomach and bowel Feeling unwell or sick Effects on the nervous system Dizziness Tremor Other effects Fever Chills Hot flushes Pain. Reporting of side effects If you get any side effects, talk to your doctor or nurse. This includes any possible side effects not listed in this leaflet. 5. How to store Mecobalamin injection Keep this medicine out of the sight and reach of children. Do not use Mecobalamin injection after the expiry date on the label.