Mecobal (Methylcobalamin (Vitamin B12))
Also sold as: Mecobal, Nervijen, Methylcal, Mecoz
Pregnancy
Cat A
Lactation
Safe
Schedule
OTC
Forms
Tablet 500/1500mcg +2
Indications
- B12 deficiency (megaloblastic anemia, pernicious anemia)
- Diabetic neuropathy
- Peripheral neuropathy of various etiologies
- Post-bariatric surgery deficiency
- Vegetarian/vegan supplementation
Adult Dosing
B12 deficiency
1000 mcg IM daily × 1 week, then weekly × 4 weeks, then monthly
Oral supplementation
1000-2000 mcg PO OD
Diabetic neuropathy
500-1500 mcg PO TDS
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| No adjustment needed | No CrCl-based dose adjustment required |
Pregnancy & Lactation
Pregnancy: Category A
Required in pregnancy; common deficiency in Indian vegetarian diet
Lactation: Safe
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Metformin (long-term) | Reduced B12 absorption — supplement | Moderate |
| PPIs, H2-blockers (long-term) | Reduced B12 absorption | Moderate |
| Colchicine, neomycin | Reduced absorption | Moderate |
| Chloramphenicol | Reduced hematologic response | Moderate |
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Side Effects
Common
- Generally well-tolerated
- Rare: rash, diarrhea
Serious / Discontinue If
- Anaphylaxis (parenteral, very rare)
Contraindications
- Hypersensitivity
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Mecobal 1500 | Eris | 10 tab ₹85 |
| Nervijen Plus | Sun Pharma | 10 tab ₹65 |
| Mecoz Forte | Cipla | 15 tab ₹95 |
Monitoring Required
- Serum B12 (target >300 pg/mL), CBC, MCV, methylmalonic acid if borderline
Patient Counseling Points
- Vegetarians/vegans should supplement lifelong
- Diabetics on metformin need periodic B12 check
- Effect on neuropathy may take 6-12 months
- Sublingual or oral usually as effective as injection
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References
- BNF
- Lexicomp Drug Information
- Indian National Formulary
- Specialty society guidelines (RSSDI/CSI/IAP)