Mecobalamin

ATC code

B03BA05

Therapeutic class

Vitamin B12 (analogue) · Coenzyme form of Vitamin B12

Forms

oral tablet, sublingual tablet, injectable solution

Brand names

Methycobal (JP) · Elenerv (PH) · Cobametin (TR)

Overall confidence

medium

Regulatory sources consulted

WHO ATC Index 2024
General Clinical Pharmacology Knowledge Base
RxNorm rxcui 29421 ↗

Approved indications

Treatment of peripheral neuropathy, especially diabetic neuropathy.
Treatment of megaloblastic anemia due to vitamin B12 deficiency.

Contraindications

Absolute

Known hypersensitivity to mecobalamin, cobalamins, or any component of the formulation.

Clinical warnings

In megaloblastic anemia, do not administer without a differential diagnosis for folate deficiency. B12 treatment can mask a concurrent folate deficiency, allowing the progression of neurological damage. — Clinical Practice

Drug interactions

LowMetforminA10BA02
Mechanism: Reduces calcium-dependent absorption of vitamin B12 in the terminal ileum. Long-term use can lead to deficiency.
Recommendation: Monitor B12 levels in patients on long-term metformin. Consider supplementation if necessary.
Clinical Practice
LowProton Pump Inhibitors (e.g., Omeprazole)A02BC01
Mechanism: Gastric acid suppression reduces the release of B12 from food proteins, decreasing its absorption. Mainly affects dietary B12, not supplemental forms.
Recommendation: Long-term use (>2 years) may require monitoring of B12 levels. Supplementation with mecobalamin (free form) is not affected.
Clinical Practice

Adverse events

Common (≥1%)

nausea · diarrhea · skin rash · loss of appetite

Rare but serious

anaphylactic reactions

Pregnancy and lactation

FDA category: Not Assigned

Generally considered safe during pregnancy and lactation when used at recommended doses. Vitamin B12 is an essential dietary component and is necessary for fetal and neonatal development.