Cyanocobalamin: here's the fair price
This is what US pharmacies pay, on average, for cyanocobalamin. Use it to spot a fair cash price, and feel good about asking for one.
Cyanocobalamin 500 Mcg Spray
A fair cash price is usually this cost plus a dispensing fee. If your quote is many times higher, ask about a generic, another pharmacy, or a cash discount.
Ask for generic Cyanocobalamin 500 Mcg Spray. Pharmacies pay about $2,593.00 for 30. Ask your pharmacy for its cash price and compare it with your copay. A fair cash price is close to this cost plus a dispensing fee.
Source: CMS NADAC as of 2026-11-04. Ask your prescriber or pharmacist whether a generic is right for you.
Source: CMS NADAC weekly file as of 2026-11-04. Median across NDCs with the same description. Public domain.
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Every strength and form
| Product | Pharmacy cost | 30 count | Effective |
|---|---|---|---|
| CYANOCOBALAMIN 30,000 MCG/30 MLGeneric | $0.80 per mL | n/a | 10/21/2026 |
| CYANOCOBALAMIN 1,000 MCG/ML VLGeneric | $1.45 per mL | n/a | 10/21/2026 |
| CYANOCOBALAMIN 10,000 MCG/10 MLGeneric | $2.64 per mL | n/a | 10/21/2026 |
| CYANOCOBALAMIN 500 MCG SPRAYGeneric | $86.43 per tablet or capsule | $2,593.00 | 10/21/2026 |
Source: CMS NADAC, as of 2026-11-04. National average acquisition cost, not a retail quote.
Label basics
What it is used for (FDA label)
INDICATIONS AND USAGE Cyanocobalamin is indicated for vitamin B 12 deficiencies due to malabsorption which may be associated with the following conditions: Addisonian (pernicious) anemia Gastrointestinal pathology, dysfunction, or surgery, including gluten enteropathy or sprue, small bowel bacteria overgrowth, total or partial gastrectomy Fish tapeworm infestation Malignancy of pancreas or bowel Folic acid deficiency It may be possible to treat the underlying disease by surgical correction of anatomic lesions leading to small bowel bacterial overgrowth, expulsion of fish tapeworm, discontinuation of drugs leading to vitamin malabsorption (see Drug/Laboratory Test Interactions ), use of a...
Common side effects (FDA label)
ADVERSE REACTIONS Generalized: Anaphylactic shock and death have been reported with administration of parenteral vitamin B 12 (see WARNINGS ). Cardiovascular: Pulmonary edema and congestive heart failure early in treatment; peripheral vascular thrombosis Hematological: Polycythemia vera Gastrointestinal: Mild transient diarrhea Dermatological: Itching; transitory exanthema Miscellaneous: Feeling of swelling of entire body To report SUSPECTED ADVERSE REACTIONS, contact Meitheal Pharmaceuticals Inc. at 1-844-824-8426 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch .
Warnings (from the label)
WARNINGS Patients with early Leber's disease (hereditary optic nerve atrophy) who were treated with cyanocobalamin suffered severe and swift optic atrophy. Hypokalemia and sudden death may occur in severe megaloblastic anemia which is treated intensely. Anaphylactic shock and death have been reported after parenteral vitamin B 12 administration. An intradermal test dose is recommended before cyanocobalamin injection is administered to patients suspected of being sensitive to this drug. This product contains benzyl alcohol. Benzyl alcohol has been reported to be associated with a fatal "Gasping Syndrome" in premature infants. This product contains aluminum that may be toxic. Aluminum may...
Source: FDA drug label via openFDA, label effective 2025-06-12. Full label on DailyMed. Excerpts are verbatim and truncated. Read the full label and ask your pharmacist.