Cyanocobalamin nasal gel is used to prevent a lack of vitamin B12 that may be caused by any of the following: pernicious anemia (lack of a natural substance needed to absorb vitamin B12 from the intestine); certain diseases, infections or medications that decrease the amount of vitamin B12 absorbed from food; or a vegan diet (strict vegetarian diet that does not allow any animal products including eggs and dairy products). Lack of vitamin B12 can cause anemia (condition in which the red blood cells do not bring enough oxygen to the organs) and permanent damage to the nerves. This anemia must be treated with vitamin B12 injections. After the red blood cells have returned to normal, cyanocobalamin nasal gel can be used to stop anemia and other symptoms of lack of vitamin B12 from coming back. Cyanocobalamin nasal gel is also used to supply extra vitamin B12 to people who need unusually large amounts of this vitamin because they are pregnant or have certain diseases. Cyanocobalamin nasal gel is in a class of medications called vitamins. It enters the bloodstream through the nose, so it can be used to supply vitamin B12 to people who cannot take in this vitamin through the intestine.