1 What is Cyanokit?

Brand: Cyanokit

Generic: Hydroxocobalamin

Brand name:


Hydroxocobalamin is indicated for the emergency treatment of suspected or known cyanide poisoning. This occurs when there is inhalation, ingestion, or dermal exposure to cyanide, which is a poisonous gas that inhibits the body’s ability to absorb oxygen.

Cyanide poisoning is life-threatening and should be treated immediately. Common symptoms of cyanide poisoning can include:

Signs can include:

  • Seizures
  • Mydriasis
  • Tachypnea
  • Bradypnea
  • Hypertension
  • and Cardiovascular Collapse

Hydroxocobalamin should be administered by a physician or trained healthcare professional. It is usually in powder form for reconstitution.

2 What to Know Before Using

Even though life or death situations may not give you the time to consider the pros and cons of using hydroxocobalamin, you should still be aware of the different factors that could affect this medication’s efficacy.

Patients who’ve had allergic reactions to hydroxocobalamin or cyanocobalamin should not be given this medication. Alternative therapies must be considered.

There has not been enough research done regarding the effects of this medication on pediatric patients. However, for geriatric patients, studies have shown that age-related factors do not limit the efficacy of hydroxocobalamin.

Inform your doctor if you are pregnant or think you are pregnant. Maternal cyanide poisoning can also cause fetal cyanide poisoning. Therefore, treatment will be beneficial to both the mother and the unborn child.

Hydroxocobalamin has been found to cause little risk for nursing infants. Give your physician a complete list of all the medications you are currently taking since hydroxocobalamin can interact with those although no formal studies have been done regarding this issue.

Ask your healthcare team if you need to avoid certain foods or beverages. This medication should be used with caution in patients with hypertension or hypotension as it may exacerbate these.

3 Proper Usage

The first dose of hydroxocobalamin may be given by an emergency care provider or a doctor. This is usually 5 g or 1 vial by intravenous infusion over a 15-minute period with 0.9% sodium chloride injection as the recommended diluent.

A second dose of 5 g may be necessary depending on your condition and response to the first dose, which brings the total to 10 mg. However, the infusion rate of the second dose may be over 15 minutes to 2 hours.

This medication should be given in a separate intravenous line.

4 Precautions to Take

Your physician needs to monitor your progress to ensure the medication is working properly and to prevent the development of side effects. It is, therefore, important to keep your follow-up appointments.

Intravenous hydroxocobalamin can cause serious allergic reactions. Signs and symptoms include:

Tell your doctor right away if you start experiencing these. This medication can also alter your blood pressure. It can either decrease or increase it. Notify your physician or healthcare team if you have fast/slow, pounding, or uneven heartbeats while the medication is being infused.

Once you are discharged, you need to avoid direct exposure to sunlight as hydroxocobalamin can increase your skin’s sensitivity to sunlight. It can also cause skin redness.

These usually last up 2 weeks after hydroxocobalamin administration. Another thing to look out for is acne-like rashes. This usually appears within 7 to 28 days post-treatment. It will get better within a few weeks.

5 Potential Side Effects

Hydroxocobalamin also causes a number of side effects. However, you may only experience some of these or none at all. Notify your healthcare team if you experience:

  • Dizziness
  • Blurred vision
  • Headache
  • Nervousness
  • Redness of the Skin
  • Pounding in the Ears
  • and Slow or Fast Heartbeat

This medication could also cause:

  • Coughing
  • Swelling of the Face and Limbs
  • Labored Breathing
  • Swallowing Difficulty
  • Feeling of Warmth
  • Skin Rash or Hives
  • Puffiness Eyelids
  • Rapid Weight Gain
  • Sudden Sweating
  • Chest Tightness
  • Tingling of the Hands or Feet
  • and Unusual Weakness

Common side effects that may subside without medical treatment include:

  • Skin Blemishes
  • Nausea
  • Pimples
  • and Red Colored Urine

You may also experience:

  • Sour Stomach
  • Forgetfulness
  • Belching
  • Diarrhea
  • Indigestion
  • Redness or Swelling of the Eyes
  • Restlessness
  • and Stomach Discomfort

If you experience side effects that are not mentioned, check with your healthcare provider as soon as possible. Notify your physician if your symptoms do not get better or get worse.