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Drug Interactions Several common medications reduce B12 absorption: Metformin (diabetes) significant reduction in B12 absorption Proton pump inhibitors (Omeprazole, Pantoprazole) reduce stomach acid needed for absorption H2 blockers (Ranitidine, Famotidine) similar effect to PPIs Colchicine (gout) may reduce B12 absorption If you take any of these medications long-term, B12 supplementation is strongly recommended