Hydroxocobalamin is used as a form of vitamin B12 to treat and prevent vitamin B12 deficiency including conditions such as pernicious anemia and it is also used as an antidote for cyanide poisoning.

The purpose of hydroxocobalamin is to restore adequate vitamin B12 levels for normal red blood cell production nerve function and DNA synthesis and to bind cyanide to form a non-toxic compound that can be eliminated from the body.

Hydroxocobalamin is a naturally occurring form of vitamin B12 containing a cobalt ion at its center. It is used as a pharmaceutical ingredient because of its effectiveness in correcting vitamin B12 deficiency and its ability to rapidly neutralize cyanide in emergency medical treatment.