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Vitamin B12 Drug Interactions

Vitamin B12 Interactions Explained

The following sections explain in detail the potentially negative interactions that can occur when vitamin B12 is combined with any of the drugs listed above.
Chloramphenicol
Chloramphenicol can prevent vitamin B12 from working to correct anemia. In general, this combination should be avoided.
Folic Acid
Folic acid can mask a vitamin B12 deficiency. It can correct the anemia while allowing the nerve damage to continue. Do not take high doses of folic acid (greater than 1 mg) without your healthcare provider's supervision.
H2 Blockers
Stomach acid is necessary to release the vitamin B12 in foods, but not in supplements. H2 blockers decrease the production of stomach acid and can, therefore, decrease the amount of vitamin B12 absorbed from foods. H2 blockers are not expected to cause a significant interaction with vitamin B12 supplements.
Metformin
Metformin may indirectly decrease the absorption of vitamin B12. This can be corrected by supplementation or, interestingly, by taking calcium supplements.
 
Proton Pump Inhibitors (PPIs)
Stomach acid is necessary to release the vitamin B12 in foods, but not in supplements. PPIs decrease the production of stomach acid and can, therefore, decrease the amount of vitamin B12 absorbed from foods. PPIs are not expected to cause a significant interaction with vitamin B12 supplements.

Final Thoughts on Drug Interactions With Vitamin B12

It is possible that not every drug interaction was discussed in this article. Therefore, you should talk with your pharmacist or healthcare provider about the vitamin B12 drug interactions that may apply to you.

More Headlines in Vitamin B12 Drug Interactions

↶ An Introduction to Vitamin B12 Drug Interactions
Last reviewed by: Kristi Monson, PharmD
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