Description of the medicine: Cobamamide (Cobamamidum)
Co a - [a - (5, 6-dimethylbenzimidazolyl)] - Co b-adenosyl cobamide.
Synonyms: Adenosylcobalamin, Adenosylcobalamin, Cobamamidum dibencozide, Coenzym B12.
Dark red crystalline powder. Hygroscopic. Soluble in water; practically insoluble in alcohol.
Chemically, cobamamide differs from cyanocobalamin in that the cobalt atom is connected by a covalent bond, not with the cyano group, but with the β-5′-deoxyadenosyl residue.
Cobamamide is a coenzyme form of vitamin B 12, i.e., one into which cyanocobalamin must be converted in order to exert its physiological (and therapeutic) effects.
Like cyanocobalamin, cobamamide is involved in a number of biochemical reactions that ensure the vital activity of the body (in the transfer of methyl groups, in the synthesis of nucleic acids, protein, in the exchange of amino acids, carbohydrates, lipids, etc.). It has a therapeutic effect not only with 12 deficiency anemia, but also with diseases of the nervous system, hypotrophic processes, etc. The drug has anabolic activity.
It is used as an anabolic agent in newborns with low body weight and symptoms of malnutrition, in young children with weakened appetite and reduced body weight, in adults with anorexia nervosa and asthenia syndrome. Also used in diseases of the peripheral nervous system (neuralgia, traumatic injuries, etc.); In 12 deficiency anemia in the complex therapy of liver diseases (chronic hepatitis, cirrhosis, fatty degeneration), chronic enterocolitis, etc.
Cobamamide is administered orally or parenterally (intramuscularly, subcutaneously, intravenously).
Children inside are prescribed 0.0002 g (200 mcg) - 0.0005 g (500 mcg) 2 - 5 times a day (half an hour before meals). For ease of use, dissolve the tablet (without shell) in a 5% solution of glucose or boiled water (25 - 50 ml). Dose for adults - 0.0005 - 0.001 g 1 - 6 times a day. The course of treatment usually lasts 7 to 30 days.
Children are administered intravenously or intramuscularly 1 time per day at 0.0005 g per injection; the course of treatment is 7 to 10 days.
Adults with anorexia nervosa syndrome and asthenia are prescribed orally at 0.0005 - 0.001 g 3-6 times a day (daily dose up to 0.003 g). The course of treatment is from 1 to 3 months.
For diseases of the peripheral nervous system, in 12-deficient anemia, chronic lymphocytic leukemia, intramuscular injection of 0.0005 0.001 g (500 - 1000 μg) 1 time per day daily for a month, or 0.0005 - 0.0015 g every other day ( with 12 deficiency anemia). The course of treatment 20 - DA injections. If necessary, after 2 to 6 months the course is repeated.
In the complex therapy of chronic hepatitis, fatty liver, cirrhosis, chronic pancreatitis and enterocolitis, cobamamide is prescribed intramuscularly at a dose of 0,00025 - 0,0005 g (250 - 500 μg) 1 time per day after 3 days; on a course of 10 to 15 injections.
There is evidence of the effectiveness of cobamamide in the treatment of inflammatory and dystrophic myocardial lesions.