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Vitamin B12 (Cobalamin) Interactions

The following are the medications and supplements that are more likely to cause a reaction with vitamin B12 (cobalamin supplements:

• Aminosalicylates
  People taking aminosalicylates may have decreased absorption of vitamin B12 (cobalamin) from the foods they eat, so may need supplementation.
• Antibiotics
  People taking antibiotics may have incorrect (false low) lab results for blood levels of vitamin B12 (cobalamin).
• Chloramphenicol
  People taking chloramphenicol should not take vitamin B12 (cobalamin) at the same time, especially if the vitamin B12 (cobalamin) is being used to treat anaemia, as the effectiveness of the vitamin B12 (cobalamin) may be greatly reduced.
• Cholestyramine
  People taking cholestyramine to reduce high levels of LDL ("bad") cholesterol may have a decreased absorption of vitamin B12 (cobalamin) from foods eaten and could need supplementation.
• Colchicine
  People taking colchicine to relieve gout may have a decreased absorption of vitamin B12 (cobalamin) from foods eaten and could need supplementation.
  
• Epoetin
  People taking epoetin to increase production of red blood cells may have a decreased absorption of vitamin B12 (cobalamin) from foods eaten and could need supplementation.

Vitamin B12 (cobalamin) has interactions with a number of medications and supplements

• Folic acid (folate)
  People taking high doses of folic acid (folate) may have a vitamin B12 (cobalamin) deficiency and not realise it. Supplementation may be required, but only after folic acid (folate) levels have been decreased and vitamin B12 (cobalamin) levels have been then tested to determine if deficiency exists.
• Metformin
  People taking metformin to lower blood glucose levels may have a decreased absorption of vitamin B12 (cobalamin) from foods eaten and could develop a deficiency, so supplementation may be necessary.
• Neomycin (oral form)
  People taking neomycin, an antibiotic used for bacterial infection may have a decreased absorption of vitamin B12 (cobalamin) from foods eaten and could develop a deficiency if the neomycin is being taken over a long term, so supplementation may be required.
• Oral contraceptives
  Women taking oral contraceptives may have a decreased absorption of vitamin B12 (cobalamin) from foods eaten, which may require supplementation in some women (especially if the diet is lower in foods high in vitamin B12).
• Potassium (slow release form)
  People taking the slow-release form of potassium may have a decreased absorption of vitamin B12 (cobalamin) from foods eaten, which may results in a deficiency in some people and may require supplementation.
• Zidovudine
  People taking zidovudine for HIV infection may have decreased absorption of vitamin B12 (cobalamin) from foods eaten, but in this case, supplementation may not be helpful or recommended.

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