Vitamin B12a · Hydroxocobalamin · Cyanide antidote · Cobinamide
1,000 mcg · vegan · gluten-free · 60 caps
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Hydroxocobalamin is a form of vitamin B12 (cobalamin) where the cobalt atom is bound to a hydroxo (OH) group. It is the preferred form for intramuscular B12 injections in many countries (UK, Europe) because it has a longer half-life than cyanocobalamin and does not contain cyanide. It is also the first-line antidote for cyanide poisoning.
Hydroxocobalamin binds cyanide to form cyanocobalamin (vitamin B12), which is non-toxic and excreted in urine. This is the basis for its use as a cyanide antidote. As a B12 supplement, hydroxocobalamin is converted to methylcobalamin and adenosylcobalamin (the active coenzyme forms) in the body. It has a longer tissue retention time than cyanocobalamin, requiring less frequent injections for B12 deficiency maintenance.
Individuals with pernicious anemia or B12 deficiency requiring injection therapy. Those with cyanide poisoning (emergency medical use only). People who prefer to avoid the cyanide moiety in cyanocobalamin. Vegans and vegetarians with B12 deficiency. NOT a general wellness supplement.
Individuals with Leber's hereditary optic neuropathy should avoid all forms of B12. Those with polycythemia vera should avoid. Pregnant women should use only under physician guidance. Hydroxocobalamin injections can cause transient pink/red discoloration of skin and urine.
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✓ Morning injections allow daytime monitoring of any adverse reactions.
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Review
→ Hydroxocobalamin is effective for cyanide poisoning. 5g IV decreases whole blood cyanide by 59%. Safe with minimal adverse effects.
69 smoke inhalation victims
→ 72% survived after hydroxocobalamin. In confirmed cyanide poisoning (n=42), 67% survived. Well tolerated.
14 severe poisoning patients
→ 71% of severe cyanide poisoning patients survived after hydroxocobalamin. Of 11 with cyanide >100 micromol/L, 7 survived.
B+ · Hydroxocobalamin has strong evidence as a cyanide antidote with well-established pharmacokinetics and survival data. As a B12 supplement, it is the standard injectable form in Europe with longer half-life than cyanocobalamin. However, for general B12 supplementation, oral methylcobalamin or cyanocobalamin are more accessible and equally effective for most users.
SacredBod's longer take on Hydroxocobalamin — context the structured blocks above don't capture.
Hydroxocobalamin is a form of vitamin B12 (cobalamin) where the cobalt atom is bound to a hydroxo (OH) group. It is the preferred form for intramuscular B12 injections in many countries (UK, Europe) because it has a longer half-life than cyanocobalamin and does not contain cyanide. It is also the first-line antidote for cyanide poisoning. The human research base is hydroxocobalamin has strong evidence as a cyanide antidote with well-established pharmacokinetics and survival data.
Hydroxocobalamin binds cyanide to form cyanocobalamin (vitamin B12), which is non-toxic and excreted in urine. This is the basis for its use as a cyanide antidote. As a B12 supplement, hydroxocobalamin is converted to methylcobalamin and adenosylcobalamin (the active coenzyme forms) in the body. It has a longer tissue retention time than cyanocobalamin, requiring less frequent injections for B12 deficiency maintenance.
Individuals with pernicious anemia or B12 deficiency requiring injection therapy. Those with cyanide poisoning (emergency medical use only). People who prefer to avoid the cyanide moiety in cyanocobalamin. Vegans and vegetarians with B12 deficiency. NOT a general wellness supplement.
Individuals with Leber’s hereditary optic neuropathy should avoid all forms of B12. Those with polycythemia vera should avoid. Pregnant women should use only under physician guidance. Hydroxocobalamin injections can cause transient pink/red discoloration of skin and urine.
Typical dose: 1,000 mcg IM injection every 2-3 months for maintenance; 1-5g IV for cyanide poisoning
Best timing: As directed by physician for deficiency; emergency use for cyanide. Morning injections allow daytime monitoring of any adverse reactions.
With food: For oral forms, take with food to improve absorption. For injections, food timing is irrelevant.
Practical notes: Hydroxocobalamin is NOT widely available as an oral supplement in India. It is primarily used as an injectable form in clinical settings. Oral cyanocobalamin or methylcobalamin are the standard B12 supplements for general use. The 2012 review confirms hydroxocobalamin is effective for cyanide poisoning with a good safety profile.
Pairs well with: Methylfolate for complementary methylation support. Iron if co-existing iron deficiency anemia. Vitamin C to enhance B12 absorption from food sources.
Avoid combining with: Avoid combining with high-dose vitamin C supplements at the exact same time if taking oral B12—vitamin C may destroy B12 in the GI tract. Space by 2 hours.
Common stacks: methylfolate, iron, vitamin-c
In India, this supplement is not readily available on major e-commerce platforms; TBD000000 indicates no verified amazon.in listing. Prices typically range from premium import prices or are unavailable. Import costs and limited availability make this inaccessible for most Indian consumers. The Indian vitamin market is highly competitive with both domestic and imported options. Always verify third-party testing for purity, especially for fat-soluble vitamins where overdose risk exists. Store in cool, dry conditions away from direct sunlight.
Hydroxocobalamin should be viewed as adjunctive nutritional support, not a replacement for established medical therapy or standard vitamin forms. For the conditions mentioned, standard alternatives often outperform: oral methylcobalamin or cyanocobalamin for general B12 supplementation. The specialized vitamin form adds incremental benefit with a favorable safety profile in most cases but should not delay appropriate medical evaluation.
Generally well-tolerated at recommended doses. The most common adverse effects vary by compound: Transient pink/red urine and skin discoloration with injections . Severe adverse events are rare at moderate doses in healthy individuals. Discontinue and seek medical care if you experience persistent vomiting, jaundice, signs of bleeding, or severe allergic reactions.
Grade: B+
Hydroxocobalamin has strong evidence as a cyanide antidote with well-established pharmacokinetics and survival data. As a B12 supplement, it is the standard injectable form in Europe with longer half-life than cyanocobalamin. However, for general B12 supplementation, oral methylcobalamin or cyanocobalamin are more accessible and equally effective for most users.
methylfolate, iron, vitamin-c, methylcobalamin
Hydroxocobalamin is the gold standard cyanide antidote with 67-72% survival in confirmed poisoning, and the preferred injectable B12 form in Europe due to longer half-life. However, for general B12 supplementation, oral methylcobalamin or cyanocobalamin are more accessible, equally effective, and far cheaper. Hydroxocobalamin is NOT widely available as an oral supplement in India. Its primary relevance is clinical (injections for pernicious anemia, emergency cyanide antidote)—not general wellness supplementation.
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