Introduction About RHINOCOBAL 250MCG NASAL SPRAY

RHINOCOBAL 250MCG NASAL SPRAY contains Mecobalamin which belongs to the group of medicines called Vitamins. RHINOCOBAL 250MCG NASAL SPRAY is used as a maintenance therapy in adult patients with pernicious anaemia who are in remission status (following intramuscular vitamin B12 therapy) without the involvement of nervous system.

RHINOCOBAL 250MCG NASAL SPRAY is also used to manage adult patients with vitamin B12 deficiency that occurred due to dietary, drug-induced, and/or malabsorption factors. It is also indicated for use to manage vitamin B12 deficiency in adult patients with vitamin B12 requirements.

RHINOCOBAL 250MCG NASAL SPRAY is not recommended for use in patients allergic to mecobalamin, cobalt, and/or vitamin B12. It is also not recommended for use in patients suffering from severe Leber hereditary optic neuropathy (inherited form of vision loss), and/or runny nose/nasal blockage.

Before using RHINOCOBAL 250MCG NASAL SPRAY, inform your doctor if you have early Leber’s disease, low levels of folate/iron in your blood (associated with signs such as extreme tiredness, sore/red tongue, muscle weakness), kidney problems (such as chronic renal disease), and/or liver problems.

RHINOCOBAL 250MCG NASAL SPRAY should be used with caution during pregnancy only if it is clearly necessary. It is also used with caution in breastfeeding women and children & adolescents (aged below 18 years).  The medicine is also advised to be used with caution in elderly patients (aged above 65 years) after consulting the doctor.

The most common side effects of using RHINOCOBAL 250MCG NASAL SPRAY are headache, weakness, inflamed/swollen tongue, burning/prickling sensation in arms/legs, nausea, and/or stuffy nose. Consult your doctor if any of these side effects worsen.

Uses Of RHINOCOBAL 250MCG NASAL SPRAY

• As a maintenance therapy in adult patients with pernicious anaemia who are in remission status (following intramuscular vitamin B12 therapy) without the involvement of the nervous system
• Manage adult patients with vitamin B12 deficiency that occurred due to dietary, drug-induced, and/or malabsorption factors
• Prevents vitamin B12 deficiency in adult patients with vitamin B12 requirements

How RHINOCOBAL 250MCG NASAL SPRAY Works

RHINOCOBAL 250MCG NASAL SPRAY works by increasing and restoring vitamin B12 levels in the blood thus promoting blood cell production and managing the deficiency of vitamin B12 and the occurrence of pernicious anaemia in affected individuals.

How to use RHINOCOBAL 250MCG NASAL SPRAY

Use RHINOCOBAL 250MCG NASAL SPRAY as advised by your physician. It is for intranasal use only. Gently, blow your nose to clear both nostrils. Hold RHINOCOBAL 250MCG NASAL SPRAY with your thumb on the bottom with your index & middle finger on either side of the nozzle and gently close one side of your nostril with your other index finger. Insert the nozzle into the open nostril about half an inch or as far as it feels comfortable and tilt your head slightly forward while nozzle insertion. Breathe in gently (from your nostril) and close your mouth. Press the plunger firmly upwards with your thumb and remove the nozzle. Keep your head firm for 10 to 20 seconds while gently breathing in through your nose and breathing out through your mouth. Your doctor will decide the correct dose and duration for you depending on your age, body weight and disease condition.

Side Effects Of RHINOCOBAL 250MCG NASAL SPRAY

How To Manage Side Effects

Headache:

If RHINOCOBAL 250MCG NASAL SPRAY causes a headache, then take rest and drink plenty of fluids. Try to avoid drinking alcohol. Ask your doctor to recommend a painkiller. Headaches should usually go away after the first week of taking RHINOCOBAL 250MCG NASAL SPRAY. If it lasts more than a week or is severe, inform your doctor.

Nausea:

Take RHINOCOBAL 250MCG NASAL SPRAY with or just after a meal. Stick to simple meals. Avoid eating oil-rich or spicy foods, sugary snacks and drinks. Avoid drinking too much liquid along with your meals, drink slowly in between meals. Talk with your doctor if the condition worsens.

Warning & Precautions

Pregnancy

RHINOCOBAL 250MCG NASAL SPRAY should be used with caution in pregnant women only if it is clearly necessary. Consult your doctor before using RHINOCOBAL 250MCG NASAL SPRAY.

Breastfeeding

RHINOCOBAL 250MCG NASAL SPRAY should be used with caution in breastfeeding women. Consult your doctor before using the medicine.

Kidney

RHINOCOBAL 250MCG NASAL SPRAY should be used with caution in patients with kidney problems such as chronic kidney disease. Consult your doctor before using RHINOCOBAL 250MCG NASAL SPRAY.

Liver

RHINOCOBAL 250MCG NASAL SPRAY should be used with caution in patients with liver problems. Consult your doctor before using RHINOCOBAL 250MCG NASAL SPRAY.

Allergy

Do not use RHINOCOBAL 250MCG NASAL SPRAY if you are allergic to mecobalamin, cobalt, vitamin B12, and/or any other ingredients of this medicine.

Interactions

A. Drug - Drug interactions:

Before using RHINOCOBAL 250MCG NASAL SPRAY, inform your doctor if you are taking any of the following medicine:

• chloramphenicol (used to manage bacterial infections).

B. Drug - Food interaction:

Avoid taking hot foods/liquids while administering RHINOCOBAL 250MCG NASAL SPRAY since it may cause nasal secretions and reduce the effect of the medicine. To manage such effects, administer the medicine one before/after ingesting hot foods/liquids.

Overdosage:

If you or anyone else accidentally administers too much of RHINOCOBAL 250MCG NASAL SPRAY, consult your doctor immediately or visit the nearby hospital to manage the overdose symptoms.

Synopsis

More Information

• Keep RHINOCOBAL 250MCG NASAL SPRAY out of reach of children
• Do not store RHINOCOBAL 250MCG NASAL SPRAY above 30°C

FAQs About RHINOCOBAL 250MCG NASAL SPRAY

What is RHINOCOBAL 250MCG NASAL SPRAY used for?

RHINOCOBAL 250MCG NASAL SPRAY is used as a maintenance therapy in adult patients with pernicious anaemia who are in remission status following intramuscular vitamin B12 therapy.  It is also used to manage adult patients with vitamin B12 deficiency that occurs due to dietary, drug-induced, and/or malabsorption factors. It is also indicated for use to manage vitamin B12 deficiency in adult patients with vitamin B12 requirements.

How RHINOCOBAL 250MCG NASAL SPRAY be used?

Use RHINOCOBAL 250MCG NASAL SPRAY as advised by your physician. It is for intranasal use only. Gently, blow your nose to clear both nostrils and hold RHINOCOBAL 250MCG NASAL SPRAY with your thumb on the bottom with your index & middle finger on either side of the nozzle. Gently, close one side of your nostril with your other index finger and insert the nozzle into the open nostril about half an inch or as far as it feels comfortable keeping your head slightly forward. Breathe in gently (from your nostril) and close your mouth. Press the plunger firmly upwards with your thumb and remove the nozzle. Keep your head firm for 10 to 20 seconds while gently breathing in through your nose and breathing out through your mouth. Your doctor will decide the correct dose and duration for you depending on your age, body weight and disease condition.

What are the side effects of RHINOCOBAL 250MCG NASAL SPRAY?

The most common side effects of using RHINOCOBAL 250MCG NASAL SPRAY are headache, weakness, inflamed/swollen tongue, burning/prickling sensation in arms/legs, nausea, and/or stuffy nose. Consult your doctor if any of these side effects worsen.

How RHINOCOBAL 250MCG NASAL SPRAY works?

RHINOCOBAL 250MCG NASAL SPRAY works by increasing and restoring vitamin B12 levels in the blood thus promoting blood cell production and managing the deficiency of vitamin B12 and the occurrence of pernicious anaemia in affected individuals.

Does RHINOCOBAL 250MCG NASAL SPRAY cause headaches?

Yes, RHINOCOBAL 250MCG NASAL SPRAY causes headaches as it is the commonest side effect associated with the use of RHINOCOBAL 250MCG NASAL SPRAY. If such side effects are experienced after receiving the medicine, then try to take rest and drink plenty of fluids. Try to avoid drinking alcohol. Ask your doctor to recommend a painkiller. Headaches should usually go away after the first week of receiving RHINOCOBAL 250MCG NASAL SPRAY. If it lasts more than a week or is severe, then inform your doctor.

References

1. KD. Tripathi. Drugs affecting blood and blood formation, Vitamins. Essentials of medical pharmacology. Seventh edition. 2013. Page – 606.

2. Vitamin B12. NIH National Library of Medicine. National Center for Biotechnology   Information. PubChem. November 2022. [Accessed on 4th November 2022] https://pubchem.ncbi.nlm.nih.gov/compound/70678590

3. Vitamin B12. NIH National Library of Medicine. National Center for Biotechnology   Information. PubChem. November 2022. [Accessed on 4th November 2022] https://pubchem.ncbi.nlm.nih.gov/compound/Vitamin-B12

4. Henry H L Wu, Angela Yee-Moon Wang. Vitamin B12 and chronic kidney disease. NIH National Library of Medicine. National Center for Biotechnology Information. PubMed.gov. February 2022. [Accessed on 4th November 2022] https://pubmed.ncbi.nlm.nih.gov/35337625/

5. G Frederiek Estourgie-van Burk, P Hugo M van der Kuy, Tim G de Meij, Marc A Benninga , C M Frank Kneepkens. Intranasal treatment of vitamin B12 deficiency in children. NIH National Library of Medicine. National Center for Biotechnology Information. PubMed.gov. November 2019. [Accessed on 4th November 2022] https://pubmed.ncbi.nlm.nih.gov/31758311/

6. Monique P.H. Tillemans, Eline M.V.J. Donders, Sjoerd L. Verweij, Ruud T.M. Van der Hoeven, and Kees J. Kalisvaart. Effect of Administration Route on the Pharmacokinetics of Cobalamin in Elderly Patients: A Randomized Controlled Trial. NIH National Library of Medicine. National Center for Biotechnology Information. PMC PubMed Central. December 2014. [Accessed on 4th November 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3994916/

7. Par Pharmaceutical Inc. NASCOBAL- cyanocobalamin spray. [Revised in November 2018] [Accessed on 4th November 2022] https://www.endo.com/File%20Library/Products/Prescribing%20Information/NASCOBAL_prescribing_information.html

8. Troikaa Pharmaceuticals Ltd. NASO B12. [Accessed on 4th November 2022] https://nasob12.com/about-us/

Useful Diagnostic Tests

• Complete blood count
• MMA test