Cyanocobalamin
| Evidence Level: L5 | Predicted Indications: 1 |
Table of Contents
Cyanocobalamin: Water-soluble vitamin B12 → biotin metabolic disease
One-Sentence Summary
Cyanocobalamin is a synthetic form of vitamin B12 and is marketed in Canada in several products. The TxGNN model predicts it may be relevant to biotin metabolic disease, but this rests on a model score alone: there are no registered clinical trials and only 1 general review that does not directly study this disease.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not recorded in the local data |
| Predicted New Indication | biotin metabolic disease |
| TxGNN Prediction Score | 0.9960 |
| Evidence Level | L5 |
| Canada Market Status | Marketed (marketed DINs: 8 of 10; dormant: 2) |
| Number of DINs | 10 (marketed: 8) |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Detailed mechanism-of-action data for cyanocobalamin is not available in the data compiled for this report. What is known is that it is a form of vitamin B12, a water-soluble B vitamin that acts as a cofactor in human metabolism.
A possible indirect link is that B12 and biotin are both water-soluble B vitamins that act as cofactors in related pathways. Adenosylcobalamin is needed by methylmalonyl-CoA mutase, while biotin is needed by propionyl-CoA carboxylase, and both enzymes work in propionate metabolism. This link is speculative.
The only cited publication is a 1992 review of biotechnological production of vitamins and coenzymes. It does not report any clinical use of cyanocobalamin in biotin-related disorders such as biotinidase or holocarboxylase synthetase deficiency. Standard care for biotin metabolic disease is biotin supplementation, and nothing in the data suggests that cyanocobalamin adds benefit. The high score (0.9960) is a model output only and should not be read as clinical evidence.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 1368195 | 1992 | Review | Journal of Chemical Technology and Biotechnology | General overview of biotechnological production of vitamins, coenzymes and related biochemicals; does not address cyanocobalamin treatment of biotin metabolic disease |
Canada Market Information
| DIN | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| 02465507 | CYANOCOBALAMIN INJECTION USP | Not recorded | Not recorded |
| 01987003 | CYANOCOBALAMIN INJECTION USP | Not recorded | Not recorded |
| 02463393 | CYANOCOBALAMIN INJECTION USP | Not recorded | Not recorded |
| 00521515 | VITAMIN B12 | Not recorded | Not recorded |
| 02100606 | MULTI 12 | Not recorded | Not recorded |
The list shows 5 of the 10 valid licences.
Safety Considerations
Drug Interactions: 100 interactions were found in the interaction database. The ones listed here are mostly minor:
- Minor: famotidine, ranitidine, cimetidine, nizatidine, rabeprazole, omeprazole, esomeprazole, lansoprazole, dexlansoprazole, pantoprazole, potassium chloride. These are acid-reducing drugs and potassium chloride, which may reduce B12 absorption.
- Severity not classified: metformin, glimepiride, acarbose, rosiglitazone, mesalazine, doxycycline, morphine, sucralfate.
Please refer to the package insert for warnings and contraindications.
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction is supported only by a model score. No clinical trial or publication directly studies cyanocobalamin in biotin metabolic disease, and the standard treatment is biotin itself.
To proceed, the following is needed:
- Studies or case reports showing cyanocobalamin benefit in biotin metabolic disorders
- Mechanism-of-action data for cyanocobalamin
- Warnings and contraindications from the Health Canada package inserts
- Clarification of which biotin-related disorders are meant, and whether they have any unmet need beyond biotin therapy
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.