NASCOBAL Rx

Indications for NASCOBAL:

Maintenance of normal hematologic status in pernicious anemia patients who are in remission after intramuscular Vit. B₁₂ therapy and who have no nervous system involvement. Supplementation for other Vit. B₁₂ deficiencies.

Adult Dose for NASCOBAL:

Hematological parameters must be within normal range before beginning therapy. Allow at least 1 hour before or after hot foods or liquids. Initial dose: One spray (500mcg) in one nostril once per week. Monitor response, may increase dose if serum B₁₂ levels decline.

Children's Dose for NASCOBAL:

Not recommended.

Warnings/Precautions:

Confirm diagnosis. May need supplemental folate. Leber's disease. Defer dose if nasal congestion, rhinitis, or upper respiratory infections occur. Reevaluate if low levels of Vit. B₁₂ persist despite treatment. Do not use for Schilling Test. Infection, uremia, bone marrow suppressants, and iron or folic acid deficiency may reduce response. May unmask polycythemia vera. Monitor B₁₂ blood levels 1 month after starting therapy, 1 month after any dose increase, and regularly at 3–6 month intervals. Monitor serum potassium, platelet counts. Pregnancy (Cat.C).

Interactions:

Antibiotics, methotrexate, pyrimethamine may interfere with lab tests. Colchicine, chronic heavy alcohol use may impair Vit. B₁₂ absorption.

Adverse Reactions:

Headache, nausea, rhinitis.

How Supplied:

Nasal spray (1.3mL)—1 (4 doses)