Cyanocobalamin and hydroxocobalamin are the only forms of vitamin B12 stable for storage (5139).

People use this for...

Orally or sublingually, dibencozide is used as a preparation to stimulate protein metabolism; increase muscle mass and strength; increase mental concentration, and to treat depression, anxiety, and panic attacks.

Likely Safe ...when used orally. There are no reports of toxicity from excessive amounts of cobalamins (272,5133). When tissue binding sites are saturated, excessive dibencozide is excreted in urine and bile (5133).

Pregnancy And Lactation: Insufficient reliable information available; avoid using.

There is insufficient reliable information available about the effectiveness of dibencozide.

Natural Medicines rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

Dosing & administration

    Adverse effects

    Interactions with pharmaceuticals

    CHLORAMPHENICOLInteraction Rating: Moderate Be cautious with this combination.Severity: Moderate Occurrence: Probable Level of evidence: DMay impair hematopoietic response to vitamin B12 (15).

    Interactions with herbs & supplements

    Preliminary evidence suggests that vitamin C supplements can destroy dietary vitamin B12. However, other components of food, such as iron and nitrates, might counteract this effect (9511). It isn't clear whether this interaction is clinically significant, and it can likely be avoided if vitamin C supplements are taken at least 2 hours after meals.

    Interactions with foods

    Excessive alcohol intake lasting longer than two weeks can decrease vitamin B12 absorption from the gastrointestinal tract (15).

    Interactions with lab tests

    None known.

    Interactions with diseases

    GI CONDITIONS: Ileal disease or resection, intrinsic factor deficiency can cause vitamin B12 malabsorption (272).

    Mechanism of action

    The term vitamin B12 refers to all cobalamins that are active as coenzymes in humans, including dibencozide (adenosylcobalamin), methylcobalamin, and hydroxocobalamin (5133). Cyanocobalamin, the most stable of the cobalamins, is metabolized in the body to an active coenzyme (5133). Vitamin B12 is involved in fat, protein, and carbohydrate metabolism. It is active in all cells, particularly in the bone marrow, CNS, and GI tract (272). Produced almost exclusively by microorganisms, vitamin B12 is found in animal protein and in some legumes in small amounts (272). Adults who eat meat in their diet usually ingest more than the RDA of 2.4 mcg (6243). Vitamin B12 is conserved by enterohepatic circulation. Deficiency takes about three years to develop in people with normal absorption (272). No benefit has been shown from taking large quantities of cobalamins unless an individual is deficient (272).


    15McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
    272Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
    5133Beltz SD, Doering PL. Efficacy of nutritional supplements used by athletes. Clin Pharm 1993;12:900-8. View abstract.
    5139Gilman AG, et al, eds. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 8th ed. New York, NY: Pergamon Press, 1990.
    6243Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (2000). Washington, DC: National Academy Press, 2000. Available at: http://books.nap.edu/books/0309065542/html/.
    9511Herbert V, Jacob E. Destruction of vitamin B12 by ascorbic acid. JAMA 1974;230:241-2. View abstract.
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