Vitamin B12 There is four types of parenteral Vitamin B12 available: Cyanocobalamin 100 mcg/ml and 1000 mcg/ml best used as IM to prevent rapid loss via kidneys Hydroxycobalamin IM (compounded 1000 mcg/ml or more) known as long acting B12 (binds better to plasma proteins than cyanocobalamin) Methylcobalamin IV (compounded 1000 mcg or more up to 5000 mcg/ml) Adenosylcobalamin IV Common dose is 1000 mcg IM or IV Vitamin B12 as hydroxycobalamin is synthesized exclusively by microorganisms and is found in the liver of animals bound to protein as methylcobalamin = metabolically active form of Vitamin B12 Hydroxycobalamin is a chelator of cyanide and is used in cyanide poisoning Hydroxocobalamin is most generally used for vitamin B12 replacement therapy and is considered the drug of choice for vitamin B12 deficiency by the Martindale Extra Pharmacopoeia (Sweetman, 2002) and the World Health Organization (WHO) Model List of Essential Drugs
Vitamin B12 is usually prescribed as a supplement to treat nerve damage due to its ability to preserve healthy nerve cells
Injection dosages are usually around 1,000 mcg while oral supplement dosages can range from 50 to 5,000 mcg
Based on the patient population we see in Doral, the strongest candidates typically include: Patients with chronic or multi-site injuries: TB-500s systemic distribution makes it particularly relevant for patients with injuries across more than one joint or tissue type, where localized injection alone would require multiple sites per session
BPC-157 + TB-500 is supplied as a lyophilized powder to support stability during storage and shipping
The FDA is not required to follow the committees recommendation, but PCAC votes often play an important role in the agencys decision-making process
