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DrugNascobal (cyanocobalamin) nasal spray solution [Par Pharmaceuticals]

October 2009

Therapeutic area - Vitamin deficiency


Indicated for the maintenance of normal hematologic status in pernicious anemia patients who are in remission following intramuscular vitamin B12 therapy and who have no nervous system involvement.

It is also indicated as a supplement for other B12 deficiencies, which might occur because of dietary deficiency, malabsorption, or gastrectomy.

Dosing is one spray in one nostril once weekly.

Each bottle contains 8 doses, or two months of therapy.


  • Payment by MA is allowed for those patients who can not be managed with either oral or indictable cyanocobalamin therapy OR 
  • For patients who require transportation for their cyanocobalamin injection and can not take cyanocobalmin by an oral route


Nascobal is an intranasal formulation of cyanocobalamin. It offers a non-injectable method of administration of cyanocobalamin. However, its cost is significantly higher per month. The state’s reimbursement to pharmacies per bottle is $239 per bottle. Each bottle should last for 8 doses or two months.

Cyanocobalamin is also available as monthly injection, which has an average price per dispensing of $1.19/injection plus an administration fee. Cyanocobalamin is also available OTC as oral tablets which are nominally priced ($2 to $5 per month).


MHCP Provider Call Center 651-431-2700 or 800-366-5411

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