Medication Description: Cobamamide (Cobamamidum)
Co a - [a - (5, 6-dimethylbenzimidazolyl)] - Co b -adenosylcobamide.
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 b-5'-deoxyadenosyl residue.
Cobamamide is a coenzyme form of vitamin B 12, that is, 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 functions of the body (in the transfer of methyl groups, in the synthesis of nucleic acids, protein, in the metabolism of amino acids, carbohydrates, lipids, etc.). It has a therapeutic effect not only in B 12 -deficient anemia, but also in diseases of the nervous system, hypotrophic processes, etc. The drug has anabolic activity.
Applied as an anabolic agent in newborns with low body mass and hypotrophy phenomena, in young children with weak appetite and underweight, in adults with anorexia nervosa syndrome and asthenia. 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 appoint 0.0002 g (200 μg) - 0.0005 g (500 μg) 2 to 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; course of treatment is 7 to 10 days.
Adults with anorexia nervosa syndrome and asthenia are prescribed by mouth at 0.0005 - 0.001 g 3-6 times a day (daily dose up to 0.003 g). The course of treatment from 1 to 3 months.
In diseases of the peripheral nervous system, In 12-deficient anemias, chronic lymphocytic leukemia is administered intramuscularly at 0.0005 0.001 g (500-1000 μg) once a day every day for a month, or 0.0005- 0.0015 g every other day ( with 12-deficient anemia). The course of treatment is 20 - 30 injections. If necessary, after 2 - 6 months, the course is repeated.
In the complex therapy of chronic hepatitis, fatty degeneration of the liver, cirrhosis, chronic pancreatitis and enterocolitis, cobamamide is administered intramuscularly at a dose of 0.00025 - 0.0005 g (250-500 μg) 1 time a day after 3 days; for a course of 10 - 15 injections.
There is evidence of the effectiveness of cobamamide in the treatment of inflammatory and dystrophic myocardial lesions.