Treatment of vitamin b(12)-deficiency anemia: oral versus parenteral therapy.
OBJECTIVE
To evaluate the use of oral cyanocobalamin therapy in the treatment of cobalamin (vitamin B(12))-deficient anemia.


METHODS
Primary and review articles were identified by MEDLINE search (1966-May 2000) and through secondary sources.


RESULTS
Cobalamin-deficient anemia is among the most common diagnoses in older populations. Cobalamin-deficient anemia may be diagnosed as pernicious anemia, resulting from the lack of intrinsic factor required for cobalamin absorption or as protein malabsorption from the inability to displace cobalamin from protein food sources. Several studies provide evidence that daily oral cyanocobalamin as opposed to monthly parenteral formulations may adequately treat both types of cobalamin-deficient anemias.


CONCLUSIONS
Daily oral cyanocobalamin at doses of 1000-2000 microg can be used for treatment in most cobalamin-deficient patients who can tolerate oral supplementation. There are inadequate data at the present time to support the use of oral cyanocobalamin replacement in patients with severe neurologic involvement.
Lane
Lenee A
LA
College of Pharmacy, The University of Oklahoma Health Sciences Center, Norman Regional Hospital, Norman, OK, USA. lenee-lane@ouhsc.edu
Rojas-Fernandez
Carlos
C
D000284:Administration, Oral; D000740:Anemia / Q000188:drug therapy* / Q000209:etiology; D002986:Clinical Trials as Topic; D006801:Humans; D007263:Infusions, Parenteral; D014805:Vitamin B 12 / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D014806:Vitamin B 12 Deficiency / Q000150:complications / Q000188:drug therapy*
D014805:Vitamin B 12