Hydroxocobalamin

Aliases: Cyanokit 

Indications: Known or suspected cyanide poisoning/smoke inhalation. 

Contraindications: Known anaphylactic reactions to Hydroxocobalamin or cyanocobalamin   

Concentrations: 

Injection: 5 gram

Dosing

Adult:

Indication Dose Route Note 
Cyanide Poisoning 
5 gIV infusion over
15 minutes 		Mix 5 g vial into 200 ml
isotonic crystalloid for
concentration of
25 mg/ml. 

Pediatric:

Indication Dose Route Note 
Cyanide Poisoning 
70mg/kg
Max: 5 g		IV infusion over
15 minutes 		Mix 5 g vial into 200 ml
isotonic crystalloid for
concentration of
25 mg/ml. 
Use Handtevy or Approved Pediatric Reference Guide for Amount to Administer

Precautions: None

Adverse/Side Effects: Anaphylaxis, chest tightness, edema, urticaria, pruritus, dyspnea, rash, and hypertension. Also, effects skin (turns red), urine and secretions.  

Class: Cobalamin derivative; Vitamin 

Mechanism of Action: Hydroxocobalamin binds with Cyanide to form nontoxic cyanocobalamin, which is then excreted in the urine 

Onset of ActionPeak EffectDuration of Action 
RapidVariesVaries