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Vitamin B12 Medicine Interactions Chloramphenicol: bacteriostatic antibiotic can interfere with red blood cell response to supplemental Vit B12 Proton pump inhibitors: omeprazole and lansoprazole, etc., slow gastric acid release and may interfere with VIt B12 absorption from food H2-receptor antagonists: cimetidine, famotidine and ranitidine slow the release of hydrochloric acid into the stomach and interfere with Vitamin B12 absorption from food Metformin: might reduce absorption of Vitamin B12 due to altered intestinal motility, increased bacterial overgrowth, etc

Injections are particularly good in these cases, as they bypass the tract for higher absorption rates than with food or oral supplements