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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Brand Name
Cobaltum Bromatum
Generic Name
Cobaltum Bromatum
Active Ingredient
CobaltousCategory
Vitamin C [EPC]
Salt Form
Chloride
Variants
8
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 30 [hp_C]/1 | PELLET | ORAL | 37662-0959 |
| 12 [hp_C]/1 | PELLET | ORAL | 37662-0958 |
| 200 [hp_C]/1 | PELLET | ORAL | 37662-0961 |
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Cobaltum Bromatum, you must consult a qualified healthcare professional.
| 500 [hp_C]/1 | PELLET | ORAL | 37662-0962 |
| 1 [hp_Q]/1 | PELLET | ORAL | 37662-0964 |
| 6 [hp_C]/1 | PELLET | ORAL | 37662-0957 |
| 1 [hp_M]/1 | PELLET | ORAL | 37662-0963 |
| 100 [hp_C]/1 | PELLET | ORAL | 37662-0960 |
Detailed information about Cobaltum Bromatum
Cobaltous (Cobaltous Chloride) is a pharmacological agent primarily utilized as a standardized chemical allergen for diagnostic patch testing and historically as a hematopoietic stimulant. It belongs to the class of standardized chemical allergens and trace mineral compounds.
The dosage of Cobaltous depends entirely on the intended clinical application. Because of its potential for systemic toxicity, dosing must be strictly controlled by medical professionals.
For the diagnosis of allergic contact dermatitis, Cobaltous Chloride is typically applied as part of a standardized patch test panel (such as the T.R.U.E. Test). The standard concentration is approximately 0.02 mg per square centimeter ($mg/cm^2$) of the patch. The patch is applied to healthy skin (usually the upper back) and left in place for 48 hours. The results are then read by a clinician at 48, 72, or 96 hours post-application.
In historical contexts for the treatment of anemia, adult dosages ranged from 20 mg to 50 mg of Cobaltous Chloride per day, usually divided into two or three doses. However, due to the high risk of 'Beer Drinker's Cardiomyopathy' and thyroid suppression, these doses are no longer recommended in standard clinical guidelines. Modern nutritional requirements for cobalt are met through the intake of Vitamin B12 (Cyanocobalamin).
Cobaltous is generally not recommended for pediatric use unless specifically required for diagnostic allergy testing under the supervision of a pediatric allergist.
Cobaltous is primarily excreted by the kidneys. In patients with chronic kidney disease (CKD) or acute kidney injury (AKI), the clearance of cobalt ions is significantly reduced. While topical patch testing usually involves negligible systemic absorption, oral or systemic administration in patients with renal impairment carries a high risk of accumulation and toxicity. Dose reductions or complete avoidance are necessary in these populations.
While the liver is a primary storage site for cobalt, it does not metabolize the metal. However, patients with severe hepatic impairment may have altered protein levels (like albumin), which can affect the transport and free-ion concentration of cobalt in the blood. Caution is advised, though specific dosage adjustment scales for hepatic impairment do not exist.
Elderly patients often have age-related declines in renal function. When undergoing diagnostic testing or if exposed to cobalt-containing compounds, monitoring for signs of systemic toxicity (such as neurological changes or cardiac symptoms) is vital. Clinical studies suggest that the elderly may be more susceptible to the cardiotoxic effects of cobalt.
Cobaltous compounds should be stored at controlled room temperature, typically between 20°C to 25°C (68°F to 77°F). Protect from light and moisture. For diagnostic patches, follow the manufacturer's expiration dates strictly to ensure the stability of the allergen.
In a diagnostic setting, if a patch falls off or a clinical appointment is missed, the test may need to be restarted. If you were taking a cobalt-containing supplement (as directed by a physician) and miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose. Do not double the dose to catch up, as this increases the risk of metal toxicity.
Signs of acute Cobaltous overdose include:
In the event of a suspected overdose, especially if oral ingestion has occurred, seek emergency medical attention immediately. Treatment often involves gastric lavage, the administration of activated charcoal, and the use of chelating agents (such as EDTA or Penicillamine) to help the body excrete the metal.
> Important: Follow your healthcare provider's dosing instructions exactly. Do not adjust your dose or apply extra patches without medical guidance.
When used as a diagnostic allergen, the most common side effects are localized to the site of application. These include:
Cobaltous is a potent chemical agent that must be handled with extreme care. While its use in diagnostic patches is highly controlled, patients should be aware that cobalt is ubiquitous in the environment (found in cell phones, batteries, jewelry, and industrial tools). If you have a known cobalt allergy, even trace amounts can trigger a reaction.
No FDA black box warnings for Cobaltous currently exist for its diagnostic patch form. However, clinical literature from the 1960s and subsequent toxicological reviews by the WHO (World Health Organization) emphasize that systemic cobalt exposure is a major risk factor for congestive heart failure.
Individuals with a known hypersensitivity to nickel often have a cross-sensitivity to cobalt. If you have ever had a severe reaction to 'costume jewelry' or metal watchbands, inform your doctor before undergoing a Cobaltous patch test. Although rare, anaphylaxis can occur.
There are few absolute contraindications for topical Cobaltous, but for systemic exposure, the following are critical:
Cobaltous must NEVER be used in the following circumstances:
Cobaltous is generally classified as Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. Animal studies have shown that cobalt can cross the placental barrier and may cause fetal growth retardation or skeletal abnormalities at high doses. According to the FDA-approved labeling for diagnostic allergens, patch testing during pregnancy should only be performed if the potential benefit justifies the potential risk to the fetus. It is generally recommended to wait until the postpartum period for elective diagnostic testing.
Cobalt is a natural component of breast milk as part of Vitamin B12. However, excessive cobalt from pharmacological sources or occupational exposure can be excreted into breast milk in higher concentrations. The effects on a nursing infant are not well-documented, but given the risk of thyroid suppression and cardiotoxicity, breastfeeding women should avoid supplemental Cobaltous. If a patch test is necessary, the amount of cobalt absorbed is typically too low to affect breast milk significantly.
Cobaltous is not FDA-approved for therapeutic use in children. For diagnostic purposes, it is used cautiously. Children have a higher surface-area-to-body-mass ratio, which theoretically increases the risk of systemic absorption from topical patches. Most pediatric dermatologists recommend limiting the number of allergens tested at one time in children under the age of 6. Long-term effects on growth and development from cobalt exposure have not been fully elucidated, but thyroid monitoring is recommended if exposure is chronic.
At the molecular level, Cobaltous ($Co^{2+}$) acts primarily as a chemical mimetic of hypoxia. It competes with iron for binding to the prolyl hydroxylase domain (PHD) enzymes. Normally, these enzymes use oxygen to tag Hypoxia-Inducible Factor (HIF) for destruction. By blocking this process, Cobaltous allows HIF to accumulate, which then enters the cell nucleus and activates the EPO gene, leading to increased red blood cell production.
Additionally, its classification as an Adrenergic Agonist [MoA] stems from its ability to stimulate the release of norepinephrine from sympathetic nerve endings and the adrenal medulla. This can result in transient increases in blood pressure and heart rate, followed by potential depression of cardiac function if exposure is prolonged.
The dose-response relationship of Cobaltous is steep. Small amounts are essential (as B12), but slightly higher amounts are toxic. The onset of the erythropoietic effect takes several days (as it requires gene transcription), while the onset of a skin allergy reaction (Type IV hypersensitivity) takes 48 to 72 hours. Tolerance to the toxic effects of cobalt does not occur; rather, the metal tends to accumulate in tissues like bone and the thyroid.
Common questions about Cobaltum Bromatum
Cobaltous, specifically Cobaltous Chloride, is primarily used today as a diagnostic tool in allergy patch testing. It helps doctors identify if a patient has a contact allergy to cobalt, which is common in people who react to metal jewelry or industrial materials. Historically, it was used to treat certain types of anemia because it stimulates the body to produce more red blood cells. However, this use has been largely replaced by safer medications. It is also an essential trace element found in Vitamin B12.
The most common side effects occur during skin patch testing and include redness, itching, and a small rash at the site of the patch. These symptoms are usually temporary and indicate a positive reaction to the allergen. If cobalt is absorbed systemically in large amounts, it can cause more serious issues like nausea or changes in heart rhythm. Most patients undergoing a standard diagnostic test will only experience mild, localized skin irritation. Always report severe burning or spreading rashes to your doctor.
You should avoid alcohol if you have high levels of cobalt in your system or are taking cobalt-containing supplements. Historically, the combination of cobalt and alcohol was found to cause severe, life-threatening heart failure known as 'Beer Drinker's Cardiomyopathy.' Alcohol can also increase skin sensitivity and redness, which might interfere with the results of a cobalt patch test. It is best to consult your healthcare provider about alcohol consumption during diagnostic testing. Safety is the priority when dealing with metal-based compounds.
Cobaltous is generally not recommended during pregnancy unless the diagnostic need is urgent. It is classified as Pregnancy Category C, meaning animal studies have shown potential harm to the fetus, but human data is limited. Cobalt ions can cross the placenta and potentially affect the developing baby's thyroid or growth. Most doctors recommend postponing elective allergy patch testing until after the baby is born. If you are pregnant, discuss the risks and benefits of any metal exposure with your obstetrician.
In the context of an allergy patch test, it takes about 48 to 72 hours for a reaction to become visible. This is because cobalt triggers a 'delayed' hypersensitivity reaction involving T-cells, rather than an immediate 'hives' reaction. For its historical use in treating anemia, it would take several weeks of consistent dosing to see an increase in red blood cell counts. In cases of accidental poisoning, toxic effects on the heart or thyroid can appear within days or weeks depending on the dose. The timing depends entirely on the method of exposure.
Yes, you can typically stop Cobaltous suddenly, as it does not cause a traditional withdrawal syndrome like opioids or antidepressants. If you are undergoing a patch test, the 'treatment' ends when the doctor removes the patch after 48 hours. If you are taking a supplement containing cobalt, stopping it will simply end the intake of the metal. However, any damage caused by cobalt toxicity, such as heart or thyroid issues, may require ongoing medical treatment even after you stop taking the compound. Always consult your doctor before ending a prescribed treatment.
If you miss an appointment for a cobalt patch test, you will likely need to reschedule the entire test, as the timing of the 'read' is critical. If you are taking a cobalt-containing supplement and miss a dose, take it as soon as you remember, unless it is almost time for your next dose. Never take two doses at once to make up for a missed one, as this increases the risk of metal toxicity. Because cobalt has a narrow safety window, keeping a consistent schedule is important. Contact your clinic for specific guidance on rescheduling.
Cobaltous itself does not directly cause weight gain, but it can cause hypothyroidism (an underactive thyroid) if taken in toxic amounts. Hypothyroidism is well-known for slowing the metabolism, which often leads to unexplained weight gain, fatigue, and puffiness. If you notice significant weight changes after being exposed to cobalt, it may be a sign that the metal is affecting your thyroid gland. Your doctor can perform a simple blood test to check your thyroid hormone levels. Weight gain is usually a secondary symptom of systemic toxicity.
Cobaltous can interact with several medications, especially other metal supplements like iron or zinc, which compete for absorption. It may also interact with thyroid medications and drugs that stimulate red blood cell production. Because it can affect the heart, it should be used cautiously with other heart medications. Always provide your healthcare provider with a full list of your current medications, including over-the-counter vitamins and herbal products. This helps prevent dangerous interactions or reduced effectiveness of your other treatments.
Cobaltous Chloride is a basic chemical compound and is available in various generic forms for industrial and laboratory use. In medicine, it is typically found as a generic component in standardized allergy test kits. There is no 'brand name' version of oral Cobaltous Chloride used in standard practice today, as its therapeutic use has declined. You will most likely encounter it as a generic ingredient in a diagnostic panel provided by your dermatologist or allergist. Always ensure any medical product is pharmaceutical grade.
Other drugs with the same active ingredient (Cobaltous)
While topical use is generally safe, systemic absorption or high-dose exposure can lead to life-threatening complications. Stop use and contact a doctor immediately if you experience:
> Warning: Stop taking Cobaltous and call your doctor immediately if you experience any signs of heart failure or thyroid swelling.
Prolonged exposure to Cobaltous, often through occupational inhalation or failed metal-on-metal hip implants (a condition known as metallosis), can lead to:
There are currently no standard FDA Black Box Warnings for Cobaltous when used as a diagnostic patch (T.R.U.E. Test). However, the FDA and other international health bodies have issued strong safety communications regarding the use of cobalt-containing medical devices (like certain hip replacements) due to the risk of systemic cobalt poisoning. If Cobaltous were to be used systemically, it would likely carry warnings for Cardiotoxicity and Thyroid Suppression.
Report any unusual symptoms, especially those affecting your heart or breathing, to your healthcare provider immediately.
If a patient is suspected of having systemic cobalt toxicity (e.g., from an industrial accident or a failing medical implant), the following labs are required:
Topical use of Cobaltous does not typically affect the ability to drive. However, if systemic toxicity occurs, symptoms like dizziness, tinnitus, or vision changes may impair these activities.
Alcohol should be avoided if systemic cobalt levels are elevated. Historically, the combination of alcohol and cobalt led to a unique and deadly form of heart failure. Alcohol may also exacerbate the skin irritation associated with patch testing.
For patch tests, the 'discontinuation' is simply the removal of the patch after 48 hours. For those using cobalt in research or industrial settings, immediate cessation of exposure is required if symptoms of toxicity appear. There is no 'withdrawal syndrome' associated with cobalt, but the physical damage (to the heart or thyroid) may take months to resolve or may be permanent.
> Important: Discuss all your medical conditions, especially heart or thyroid problems, with your healthcare provider before starting Cobaltous testing.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking, especially if you work in an industry with metal exposure.
These conditions require a careful risk-benefit analysis by a physician:
Patients should be aware of Cross-Sensitivity between metal ions. Approximately 25% of patients who are allergic to Nickel are also allergic to Cobalt. There is also a known cross-reactivity with Chromium. If you are allergic to one of these metals, your healthcare provider will likely test for all three simultaneously.
> Important: Your healthcare provider will evaluate your complete medical history and prior metal reactions before prescribing or using Cobaltous.
Clinical trials of diagnostic allergens often do not include sufficient numbers of subjects aged 65 and over to determine if they respond differently than younger subjects. In general, elderly patients have thinner skin, which may alter the reaction to a patch test. More importantly, the higher prevalence of underlying heart disease and reduced renal clearance in the elderly makes them more vulnerable to the systemic toxicities of cobalt. Healthcare providers should monitor cardiac function closely if systemic exposure is suspected.
In patients with a GFR (Glomerular Filtration Rate) of less than 30 mL/min, the clearance of cobalt is severely impaired. While a single diagnostic patch test is unlikely to cause issues, these patients should be monitored for signs of metal accumulation. Dialysis does remove some cobalt, but it is not as efficient as healthy kidneys.
No specific dosage adjustments are provided for patients with hepatic impairment (Child-Pugh Class A, B, or C). However, since the liver stores cobalt, patients with cirrhosis or biliary obstruction may have altered metal distribution patterns. Clinical judgment is required.
> Important: Special populations require individualized medical assessment and often a more cautious approach to diagnostic testing.
| Parameter | Value |
|---|---|
| Bioavailability | 5% - 45% (Oral) |
| Protein Binding | 50% - 70% (Mainly Albumin) |
| Half-life | 2 - 5 days (Initial); Months (Terminal) |
| Tmax | 1 - 2 hours (Oral) |
| Metabolism | None (Elemental Ion) |
| Excretion | Renal (80%), Fecal (15%) |
Cobaltous is classified as a Standardized Chemical Allergen [EPC]. Within the therapeutic hierarchy, it is grouped with other metal salts like Nickel Sulfate and Potassium Dichromate. It also holds a secondary classification as a Vitamin C [EPC] related compound in specific regulatory databases due to its historical role in redox-active therapeutic mixtures.