NASCOBAL (NAZ. co. bal)
(cyanocobalamin) nasal spray
NASCOBAL is for use in your nose only.
What is NASCOBAL?
NASCOBAL is a prescription medicine used:
- for maintenance therapy to treat vitamin B12 deficiency (low levels of vitamin B12) in adults with pernicious anemia who achieved healthy vitamin B12 levels after receiving vitamin B12 shots and do not have nervous system problems.
- to treat vitamin B12 deficiency caused by:
- certain food limitations,
- oother medicines that cause vitamin B12 deficiency, or
- lack of absorption (malabsorption) that are not related to pernicious anemia.
- to prevent vitamin B12 deficiency in adults who require higher amounts of vitamin B12.
NASCOBAL should not be used for a vitamin B12 absorption test known as the Schilling test.
In people that have corrected or have fixed their short-term causes of vitamin B12 deficiency, the benefit of continued long-term use of NASCOBAL is not known after vitamin B12 deficiency has been corrected.
It is not known if NASCOBAL is effective in people that currently have a stuffy nose, allergies or an upper respiratory infection. You should wait until these symptoms have gone away before using NASCOBAL.
It is not known if NASCOBAL is safe and effective in children.
Do not use NASCOBAL if you are allergic to cobalt, vitamin B12, cyanocobalamin or any ingredients in NASCOBAL. See the end of this leaflet for a complete list of ingredients in NASCOBAL.
Before you use NASCOBAL, tell your healthcare provider about all of your medical conditions, including if you:
- have a history of a certain disease that effects or weakens the optic nerve in your eye (early Leber’s disease). NASCOBAL is not recommended in people with Leber’s optic atrophy.
- have had an allergic reaction to vitamin B12 injections or intravenous (IV) infusion.
- have low levels of folate or iron.
- are pregnant or plan to become pregnant. It is not known if NASCOBAL will harm your unborn baby.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
How should I use NASCOBAL?
- See the Instructions for Use at the end of this leaflet for instructions on how to use NASCOBAL.
- You should use NASCOBAL exactly as your healthcare provider tells you to use it.
- Your healthcare provider will tell you how much NASCOBAL to use and when to use it.
- You should not use NASCOBAL 1 hour before or 1 hour after eating hot foods or drinking hot liquids. Eating hot food or drinking hot liquids too soon before or after taking NASCOBAL can cause you to have a runny nose and can affect the amount of NASCOBAL you receive.
- Your healthcare provider may do certain blood tests before you use NASCOBAL and every 3 to 6 months while you are taking it.
- Your healthcare provider may change your dose based on the results of your blood tests.
What are the possible side effects of NASCOBAL?
NASCOBAL can cause serious side effects, including:
- Weaken your eye nerve in patients with early Leber’s disease. Tell your healthcare provider if you or your family has a history of early Leber’s disease.
- Serious allergic reactions. Serious life-threatening allergic reactions including death have happened in people who have received vitamin B12 by injection or by intravenous (IV) infusion (parenteral). Tell your healthcare provider if you have ever had a reaction after you received vitamin B12 by injection or IV infusion.
- Hiding (masking) a folate deficiency. Your healthcare provider may do certain blood tests to check your vitamin B12 and folate levels.
- Low potassium levels (hypokalemia) and low blood platelets (thrombocytopenia) can happen in people with serious megaloblastic anemia. Your healthcare provider may monitor your potassium levels and platelets counts during your treatment with NASCOBAL.
The most common side effects of NASCOBAL include:
- infection
- headache
- feeling weak
- nausea
- swelling of your tongue
- runny nose
- tingling of the hands and feet
These are not all of the possible side effects of NASCOBAL.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
General information about the safe and effective use of NASCOBAL.
Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use NASCOBAL for a condition for which it was not prescribed. Do not give NASCOBAL to other people, even if they have the same symptoms that you have. It may harm them. You can ask your pharmacist or healthcare provider for information about NASCOBAL that is written for health professionals.
What are the ingredients in NASCOBAL?
Active ingredient: cyanocobalamin
Inactive ingredients: benzalkonium chloride in purified water, citric acid, glycerin and sodium citrate.
For more information, go to
www.endo.com or call 1-800-828-9393.
Manufactured for:
Endo USA
Malvern, PA 19355
©2024 Endo, Inc. or one of its affiliates.
This Patient Information has been approved by the U.S. Food and Drug Administration.
Revised: 03/2024