Archive for February 6, 2008

Vitamin B12 and Potential Drug Interactions

February 6, 2008 by Orville Campbell, MD.

Drug Potential Interaction
  • Proton pump inhibitors (PPIs) are used to treat gastroesophageal reflux disease (GERD) and peptic ulcer disease. Examples of PPIs are Omeprazole (Prilosec©) and Lansoprazole (Prevacid©)
    		•  PPI medications can interfere with vitamin B12 absorption from food by slowing the release of hydrochloric acid into the stomach [31-33]. This is a concern because acid is needed to release vitamin B12 from food prior to absorption. So far, however, there is no evidence that these medications promote vitamin B12 deficiency, even after long-term use [34].
  • H2 receptor antagonists are used to treat peptic ulcer disease. Examples are Tagamet©, Pepsid©, and Zantac©
    		•  H2 receptor antagonists can interfere with vitamin B12 absorption from food by slowing the release of hydrochloric acid into the stomach. This is a concern because acid is needed to release vitamin B12 from food prior to absorption. So far, however, there is no evidence that these medications promote vitamin B12 deficiency, even after long-term use [34].
  • Metformin© is a drug used to treat diabetes.
    		•  Metformin may interfere with calcium metabolism [35]. This may indirectly reduce vitamin B12 absorption because vitamin B12 absorption requires calcium [35]. Surveys suggest that from 10% to 30% of patients taking Metformin have evidence of reduced vitamin B12 absorption [35].

    **Source: http://dietary-supplements.info.nih.gov/factsheets/vitaminb12.asp

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