В12 Анкерманн Таблетки, коробка, 50 шт, 1 мг, для приема внутрь, покрытые оболочкой

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При тяжелой почечной недостаточности рекомендуется уменьшение дозы, следует регулярно контролировать концентрацию витамина B 12 в сыворотке крови."}},{"type":"paragraph","data":{"text":"Пациенты с нарушением функции печени"}},{"type":"paragraph","data":{"text":"Фармакокинетические данные и клинический опыт применения у пациентов с нарушением функций печени недоступны. Безопасность и эффективность у пациентов с нарушением функций печени не была установлена."}},{"type":"paragraph","data":{"text":"Дети"}},{"type":"paragraph","data":{"text":"Безопасность и эффективность препарата B 12 Анкерманн у детей в возрасте от 0 до 18 лет на данный момент не установлены. 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В дальнейшем оценку симптоматики, результатов общего анализа крови и среднего объема эритроцитов следует проводить каждые 4 недели в течение первых 3 месяцев лечения, а затем, при хорошей приверженности к лечению, 1 раз в течение 6–12 месяцев. При подозрении на недостаточную приверженность к лечению может потребоваться более частый контроль эффективности терапии, коррекция дозы цианокобаламина или пути введения."}},{"type":"paragraph","data":{"text":"Поскольку избыток кобаламина выводится через почки, при почечной недостаточности витамин B 12 может накапливаться, особенно у пациентов с терминальной почечной недостаточностью (требующей диализа). Для поддержания адекватной концентрации витамина В 12 в сыворотке крови необходимо регулярно определять концентрацию витамина В 12 в сыворотке крови и корректировать режим лечения."}},{"type":"paragraph","data":{"text":"Витамин В 12 нельзя использовать для лечения мегалобластной анемии, вызванной исключительно дефицитом фолиевой кислоты."}},{"type":"paragraph","data":{"text":"Следует соблюдать осторожность у пациентов с сопутствующим недостатком фолиевой кислоты. Дефицит фолиевой кислоты может ослабить терапевтический ответ на лечение витамином В 12 . У таких пациентов применение препарата B 12 Анкерманн должно сопровождаться лечением дефицита фолиевой кислоты."}},{"type":"paragraph","data":{"text":"Пациенты с дефицитом витамина B 12 , у которых повышен риск развития атрофии зрительного нерва, не должны применять цианокобаламин для лечения дефицита витамина B 12 . 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