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Interactions with Medications Vitamin B12 has the potential to interact with certain medications, including diabetic prescriptions, metformin, proton pump inhibitors, antagonists and antibiotics

Initial testing: Do CBC and B12 tests before starting treatment and again after the first dose

Metformin may result in suboptimal oral vitamin B12 absorption by competitively blocking the calcium-dependent binding of the intrinsic factor-vitamin B12 complex to its receptor

It may absorb up to 12% of water if exposed to air

Prepare a clean work area

Most side effects are dose-dependent, meaning lower doses produce fewer issues