1. Food Portion Distortion Quiz: Test Your Diet IQ
2. Food Frauds That Wreck Your Diet Slideshow
3. Foods That Help or Harm Your Sleep Slideshow

What should I discuss with my healthcare provider before using nasal cyanocobalamin (CaloMist, Nascobal)?

You should not use this medication if you are allergic to cobalt, or if you have Leber's disease. Cyanocobalamin can lead to optic nerve damage (and possibly blindness) in people with Leber's disease.

Before using cyanocobalamin, tell your doctor if you have:

• any type of infection;
• iron or folic acid deficiency;
• kidney or liver disease; or
• if you are receiving any medication or treatment that affects bone marrow.

Tell your doctor if you develop nasal congestion, a cold, or allergies. Nasal cyanocobalamin may not work as well if your nose is congested.

FDA pregnancy category C. It is not known whether this medication can harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Cyanocobalamin passes into breast milk, but it is not known whether cyanocobalamin could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I use nasal cyanocobalamin (CaloMist, Nascobal)?

Use this medication exactly as prescribed by your doctor. Do not use it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Your dose needs may change if you become pregnant, if you breast-feed, or if you eat a vegetarian diet. Tell your doctor about any changes in your diet or medical condition.

To use nasal cyanocobalamin.

• Gently blow your nose to clear any mucus.
• Prime the nasal gel pump before your first use and whenever it has been longer than 2 days between uses. Pump the gel unit several times until a gel droplet appears at the tip, then pump 2 more times.
• Prime the nasal spray before your first use by pumping the spray a few times until a fine mist appears. Prime the pump 1 time before each use thereafter.
• Insert the tip of the nasal pump about half an inch into your nostril, pointing it toward the back of the nose.
• Gently press your other nostril closed with your finger, and tilt your head forward. Pump and sniff gently at the same time. Return your head to an upright position.
• Remove the pump from your nose. Rub your nostril gently for a few seconds.
• Clean the tip of the spray or gel pump with a clean tissue and recap.

To be sure this medication is helping your condition, your blood will need to be tested every 3 to 6 months. This will help your doctor determine the correct dose and how long to treat you with cyanocobalamin. Do not miss any scheduled appointments.

To treat pernicious anemia, you will have to use this medication on a regular basis for the rest of your life. Not using the medication can lead to irreversible nerve damage in your spinal cord.

Pernicious anemia is also treated with folic acid to help maintain red blood cells. However, folic acid will not treat Vitamin B12 deficiency and will not prevent possible damage to the spinal cord. Use all of your medications as directed.

Store this medication at room temperature away from moisture, heat, and light. Keep the nasal gel in the prescription vial when not in use. Store the nasal spray upright.

Need help identifying pills and medications?
Use the pill finder tool on RxList.