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Drug Interactions between B-12 Resin and Tritec

This report displays the potential drug interactions for the following 2 drugs:

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Minor

cyanocobalamin raNITIdine bismuth citrate

Applies to: B-12 Resin (cyanocobalamin) and Tritec (ranitidine bismuth citrate)

By reducing or suppressing gastric acid secretion, H2-receptor antagonists and proton pump inhibitors may interfere with the gastrointestinal absorption of vitamin B12, a process that is dependent on the presence of gastric acid and pepsin. Clinical studies have shown that dietary (i.e., protein-bound) vitamin B12 malabsorption can occur during treatment with these agents, particularly proton pump inhibitors, although the likelihood of developing clinically significant deficiency over time is unknown. There has been one reported case of vitamin B12 deficiency with megaloblastic anemia in a patient who received omeprazole at a minimum of 40 mg/day for 4 years. Also uncertain is whether acid reduction or suppression can affect the absorption of vitamin B12 ingested in the form of oral supplements such as cyanocobalamin. Non-oral routes of administration (e.g., parenteral, intranasal, sublingual) are generally preferred in the treatment of B12 deficiency-related anemia.

References

  1. Salom IL, Silvis SE, Doscherholmen A "Effect of cimetidine on the absorption of vitamin B12." Scand J Gastroenterol 17 (1982): 129-31
  2. Marcuard SP, Albernaz L, Khazanie PG "Omeprazole therapy causes malabsorption of cyanocobalamin (vitamin-b12)." Ann Intern Med 120 (1994): 211-5
  3. Lavy NW "Omeprazole and vitamin B12." Ann Intern Med 121 (1994): 74
  4. Dutta SK "Vitamin b-12 malabsorption and omeprazole therapy." J Am Coll Nutr 13 (1994): 544-5
  5. Bradford GS, Taylor CT "Omeprazole and vitamin B-12 deficiency." Ann Pharmacother 33 (1999): 641-3
View all 5 references

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Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Therapeutic duplication warnings

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Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

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