Neural 0.5 mg Tablet

Active form of vitamin B12 used for:

• Peripheral neuropathy (diabetic neuropathy, nerve pain, numbness, tingling)
• Vitamin B12 deficiency and megaloblastic anaemia
• Supportive treatment in nerve injury, sciatica, carpal tunnel syndrome

Oral (adults): 500 microgram three times daily (1500 microgram/day), or 1500 microgram once daily; adjust by response.

Injection: 500 microgram IM or IV three times a week; for anaemia, after about 2 months, 500 microgram every 1–3 months as maintenance.

Children: dose as advised by doctor.

• Benefit in neuropathy may take several weeks; if no benefit after 1 month, review.

• Allergy to mecobalamin or cobalamins

Uncommon: loss of appetite, nausea, diarrhoea, stomach discomfort, rash.

Injection: pain at injection site, headache, hot feeling, sweating; rarely allergic reactions (anaphylaxis).

• Find the cause of B12 deficiency (e.g. pernicious anaemia needs injections).
• Do not use long-term without benefit.
• Folic acid alone can mask B12 deficiency.

Safe at recommended doses in pregnancy and breastfeeding.

• Metformin, PPIs, H2 blockers, colchicine reduce B12 absorption (supplement may be needed)
• Chloramphenicol may reduce response in anaemia

Very low toxicity; excess is excreted in urine.

Store below 30°C, protected from light (light degrades it); keep in the blister until use.