{ "schema_version": 1, "kind": "condition", "id": "vitamin-b12-deficiency", "name": "Vitamin B12 Deficiency Anaemia", "category": "chronic", "sources": "BSH Guideline for Diagnosis and Treatment of Cobalamin and Folate Disorders 2014 for the schedule, with the dose from Egyptian National Drug Formulary - Blood disorders 2025, hydroxocobalamin monograph (endf-blood-2025.txt): \"Addisonian pernicious anemia and other macrocytic anemias with neurological involvement Initial: IM: 1 mg every other day for as long as there is improvement. Maintenance: IM: 1mg every 2 months.\" The formulary's maintenance interval is 2 to 3 months against the 3 months used here. · BSH Guideline for Diagnosis and Treatment of Cobalamin and Folate Disorders 2014", "review_status": "reviewed", "verified_against": "BSH Guideline for Diagnosis and Treatment of Cobalamin and Folate Disorders 2014 for the schedule, with the dose from Egyptian National Drug Formulary - Blood disorders 2025, hydroxocobalamin monograph (endf-blood-2025.txt): \"Addisonian pernicious anemia and other macrocytic anemias with neurological involvement Initial: IM: 1 mg every other day for as long as there is improvement. Maintenance: IM: 1mg every 2 months.\" The formulary's maintenance interval is 2 to 3 months against the 3 months used here. · BSH Guideline for Diagnosis and Treatment of Cobalamin and Folate Disorders 2014", "verified_date": "2026-08", "treatments": [ { "id": 1887, "generic": "Hydroxocobalamin", "line": 1, "is_adjunct": false, "form": "injection", "strength_mg": 1.0, "adult_dose": "1 mg IM 3 times a week for 2 weeks (without neurological symptoms), then 1 mg IM every 3 months for life", "adult_duration": "lifelong maintenance", "dose_source": "BSH Guideline for Diagnosis and Treatment of Cobalamin and Folate Disorders 2014 for the schedule, with the dose from Egyptian National Drug Formulary - Blood disorders 2025, hydroxocobalamin monograph (endf-blood-2025.txt): \"Addisonian pernicious anemia and other macrocytic anemias with neurological involvement Initial: IM: 1 mg every other day for as long as there is improvement. Maintenance: IM: 1mg every 2 months.\" The formulary's maintenance interval is 2 to 3 months against the 3 months used here.", "rationale": "Hydroxocobalamin given intramuscularly is the preferred formulation. The BSH 2014 guideline states it as practice rather than as a comparison: \"Current clinical practice within the UK is to treat cobalamin deficiency with hydroxocobalamin in the intramuscular form.\"", "cautions": [ "IF NEUROLOGICAL SYMPTOMS PRESENT (paresthesias, ataxia, subacute combined degeneration): Give 1 mg IM on alternate days until no further improvement, then 1 mg every 2 months.", "There is a hypokalemia risk: monitor serum potassium during the initial phase of rapid reticulocytosis.", "Check folate levels — giving folate alone in B12 deficiency precipitates severe irreversible subacute combined degeneration of spinal cord." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "1 mg IM on alternate days until improvement, then 1 mg IM every 2-3 months", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "DEPOLVIX B12 1MG/ML 2 I.M. AMP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA TEC", "price_egp": 10.5, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NEW ECAVIT B12 1MG/2ML 6 AMP. I.M", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 19.5, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "B12 DEPOT 1000 MCG 5 AMP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 26.25, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LONGAVIT B12 1MG/ML 3 AMP. FOR IM INJ.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 36.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DEPOVIT B12-1000MCG/ML 3 I.M. AMPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMRIYA", "price_egp": 51.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "COBALAMIN DEPOT 1000MCG/ML 5 I.M. AMP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 55.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DEPOFORT B12 1MG/ML 5 AMP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 55.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DEPOVIT B12-1000MCG/ML 5 I.M. AMPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMRIYA", "price_egp": 85.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "vitamin-b12-deficiency" }, { "id": 1888, "generic": "Cyanocobalamin", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 1.0, "adult_dose": "1000-2000 mcg (1-2 mg) orally once daily", "adult_duration": "long-term", "dose_source": "BSH Guideline for Diagnosis and Treatment of Cobalamin and Folate Disorders 2014", "rationale": "High-dose oral cyanocobalamin alternative for dietary B12 deficiency (vegans) or when IM injection is refused", "cautions": [ "The oral route is unreliable in severe pernicious anaemia or ileal resection.", "Requires compliance with high daily oral dose." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "50-100 mcg daily orally for dietary deficiency", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "B12 SR 1000MCG 20 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "INTERNATIONAL DRUG AGENCY (IDI) > NOVELL PHARMA", "price_egp": 30.0, "pack_count": 20, "unit_price": 1.5, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LIPOSOM-B12 1000 MCG 20 SUBLINGUAL TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HOCHSTER PHARMACEUTICAL INDUSTRIES", "price_egp": 60.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DELTAVIT B12 - 1 MG 30 SUBLINGUAL TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA PHARMA", "price_egp": 75.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DEVART B12 1000 MCG 30 SUBLINGUAL TABS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DEVARTLAB > BIOERA", "price_egp": 80.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LIPOSOM-B12 1000 MCG 30 SUBLINGUAL TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HOCHSTER PHARMACEUTICAL INDUSTRIES", "price_egp": 90.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "JOVEMED B12 - 1000 MCG 30 SUBLINGUAL TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEDIZEN PHARMACEUTICAL INDUSTRIES", "price_egp": 120.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "vitamin-b12-deficiency" } ] }