About mecobalamin, you need to know at least these 5 things!

*It is only for medical professionals to read for reference.
Reasonable medication is the key to treating diseases! Recently, some doctors broke the news: because the doctors prescribed mecobalamin tablets for diabetic patients who have been taking metformin for a long time, the hospital received a huge fine from the Medical Insurance Bureau
.

So, is the hospital punished or not? To answer this question, you need to know at least the following five points
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1.
The effect of metformin on vitamin B12.
Most studies believe that metformin can affect the gastrointestinal absorption of vitamin B12, reduce vitamin B12 levels, and is related to the treatment time and dose of metformin
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However, some studies believe that metformin does not reduce the total amount of vitamin B12 in the body, but only increases the vitamin B12 accumulated in the liver and reduces the vitamin B12 in the circulation
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In short, there is no conclusive conclusion about the impact of metformin and vitamin B12
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Therefore, the 2020 edition of the "Guidelines for the Prevention and Treatment of Type 2 Diabetes in China" recommends that people who have used metformin for a long time can measure their serum vitamin B12 levels once a year, and if they are deficient, supplement vitamin B12 appropriately
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2.
The medical insurance situation of mecobalamin Mecobalamin has oral agents and injections
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Indications include peripheral neuropathy, megaloblastic anemia, and vitamin B12 deficiency
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The 2019 and 2020 medical insurance catalogs do not restrict the use of oral agents.
As long as the medication is used in accordance with the drug insert, the medical insurance will pay for the drug as required
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3.
The difference between methylcobalamin, adenosylcobalamin and vitamin B12.
The parent ring structure of methylcobalamin, adenosylcobalamin and vitamin B12 is the same.
They all contain trivalent cobalt.
The injections are all red and are not stable to light.
, All need to be shaded and stored
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Vitamin B12 (cyanocobalamin) is a prodrug that has no biological activity.
It can only play a role after it is converted into methylcobalamin and adenosylcobalamin in the body
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The difference between vitamin B12, mecobalamin and adenosylcobalamin: 4.
The role of mecobalamin and adenosylcobalamin Megaloblastic anemia is a disease caused by DNA synthesis disorders
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Vitamin B12 is an important coenzyme in the process of DNA synthesis.
When vitamin B12 is lacking, the speed of DNA synthesis slows down, leading to megaloblastic anemia
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Vitamin B12 (including methylcobalamin and adenosylcobalamin) is involved in the synthesis of nerve myelin lipids to maintain the integrity of myelinated nerve fibers
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Peripheral neuropathy can occur when vitamin B12 is lacking
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Mecobalamin, adenosylcobalamin and vitamin B12 are all approved for the treatment of peripheral neuropathy and megaloblastic anemia
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However, the 2021 version of the "Experts Consensus on Diabetic Neuropathy Diagnosis and Treatment" believes that methylcobalamin is easier to enter nerve cells than inactive vitamin B12, has a significant role in promoting myelination and axon regeneration, and can repair damaged nerve cells and improve Nerve conduction velocity
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Recommended usage: Mecobalamin injection 500~1000μg/d intramuscularly or intravenously for 2~4 weeks, then 500μg mecobalamin tablets are given, orally 3 times a day, the course of treatment is at least 3 months
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5.
Adverse reactions of mecobalamin Occasionally (5%～0.
1%) loss of appetite, nausea, vomiting, diarrhea
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Injections can cause allergic reactions, even anaphylactic shock, and should not be abused
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