MIC+B12 injections

What this is

MIC+B12 is a compounded injection combining three lipotropic agents — methionine (an essential amino acid involved in fat metabolism and liver function), inositol (involved in how cells handle fat and in insulin signalling) and choline (used by the liver to export fat rather than store it) — with vitamin B12 (usually cyanocobalamin or methylcobalamin), an essential vitamin involved in red blood cell formation, nerve function and energy metabolism. DonoMed prescribes it as a subcutaneous injection on a simple guided schedule, after a licensed provider reviews your health history.

Tell your provider before starting if you

• Have Leber's hereditary optic neuropathy — cyanocobalamin can worsen it and should be avoided.
• Have had an allergic reaction to cobalamin or cobalt.
• Have kidney disease, low potassium, or a diagnosed megaloblastic anaemia.
• Have polycythaemia vera.
• Are pregnant, trying to become pregnant, or breastfeeding.
• Take metformin, a proton-pump inhibitor, colchicine, or chloramphenicol — these affect B12 levels or response.
• Have liver disease, gallbladder disease, or a history of pancreatitis — the lipotropic components act on fat handling in the liver.
• Take levodopa — methionine and B12 can affect how it works.
• Have bipolar disorder — inositol has been reported to affect mood stability in some people.

Common side effects

Injection-site pain, redness or swelling. Mild diarrhoea, nausea, stomach upset, headache, or a temporary feeling of warmth or flushing. A fishy body odour can occur with choline. Some people notice their urine turns a brighter colour, which is harmless.

Serious side effects — stop and seek care

• Serious allergic reaction. Swelling of the face, lips, tongue or throat, difficulty breathing, or widespread rash. Call 911.
• Low potassium early in treatment for severe deficiency: muscle weakness, cramps, or an irregular heartbeat.
• Signs of a blood clot: swelling, pain or warmth in a leg, or sudden shortness of breath.
• Signs of injection-site infection. Spreading redness, warmth, pus, or fever.

An important caution

Taking B12 can correct the anaemia caused by folate deficiency while allowing underlying nerve damage to progress undetected. This is one reason B12 should be prescribed and monitored by a provider rather than self-administered indefinitely without review.

Storage and handling

Store as instructed on your label, protected from light, and out of reach of children. Do not use after the beyond-use date. Never share your medication, needles or syringes. Dispose of used needles in an approved sharps container.

This summary is not complete

The information above is a summary and does not list every possible risk, interaction or side effect. Discuss your full health history and all medications and supplements you take with your provider before starting treatment.

Reporting a problem

Tell your provider about any side effect. You can also report side effects directly to the FDA at fda.gov/medwatch or by calling 1-800-FDA-1088. If you think you are having a medical emergency, call 911.