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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