Page 148 - 2023 SMOG Digital

HYDROXOCOBALAMIN Lactation? (Caution) Trade Name: Cyanokit®
Class / Mechanism of Action
Antidote; Vitamin
Precursor to Vitamin B12 (cyanocobalamin). Binds cyanide ion to form cyanocobalamin which is excreted
within urine
Indications
Labeled Indications:
• IM: Treatment of pernicious anemia and B 12 deficiencies
• IV: (Cyanokit®) Treatment of known or suspected cyanide poisoning
Contraindications
• No contraindications when treating for suspected or known cyanide poisoning
Adverse Reactions / Precautions
• May cause transient hypertension (>180mmHG systolic, >110mmHG diastolic)
• Will cause red colored urine and skin
Dose and Administration: ADULT PEDIATRIC Always Reference BROSELOW Tape
Cyanide Poisonings: Cyanide Poisonings:
IV (Note: If cyanide poisoning is suspected, IV: (Unlabeled Use)
antidotal therapy must be given immediately) • Initial: 70mg/kg (max 5g) as single infusion
• Initial: 5g as single infusion given over 15min given over 15 min
o Repeat a second 5g dose based on o Repeat a second dose of 35mg/kg
severity and clinical response. based on severity and clinical
o Maximum cumulative dose: 10g response.
Smoke Inhalation / Fire victims: (Closed space
Smoke Inhalation / Fire victims: (Closed space exposure with evidence of airway injury: soot in
exposure with evidence of airway injury: soot in mouth / nose / sputum)
mouth / nose / sputum) • May present with both cyanide and carbon
• May present with both cyanide and carbon monoxide poisoning. Hydroxocobalamin is the
monoxide poisoning. Hydroxocobalamin is the agent of choice for treating cyanide toxicity in
agent of choice for treating cyanide toxicity in this setting.
this setting.
Preparation:
Cyanokit®: Reconstitute each vial with 200mL of
NS (LR and D5W also OK).
• Do not shake vial (gently mix)
• Do not use if solution is not dark red

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