Skip to Content
Looking to save on your medications?  Find out how 

5 Interactions found for:

pantoprazole and Vitamin B12
Interactions Summary
  • 2 Major
  • 0 Moderate
  • 3 Minor
  • pantoprazole
  • Vitamin B12

Drug Interactions

Minor
Vitamin B12 + Pantoprazole

The following applies to the ingredients: Cyanocobalamin (found in Vitamin B12) and Pantoprazole

Professional Content

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

Drug and Food Interactions

No food interactions were found for selected drugs: pantoprazole, Vitamin B12.

This does not necessarily mean no interactions exist. Always consult your healthcare provider.

Drug and Pregnancy Interactions

The following applies to the ingredients: Pantoprazole

Professional Content

This drug is only recommended for use during pregnancy when there are no alternatives and the benefit outweighs the risk.
-Some experts state that this drug should not be used in pregnancy.

AU TGA pregnancy category: B3
US FDA pregnancy category: Not assigned.

Risk summary: Observational studies indicate that an association of major malformations or adverse events with use of this drug during pregnancy; however, drug-associated risks cannot definitively be established or excluded by observational studies due to methodological limitations.

Animal models have revealed evidence of changes to femur bone length and weight when given during gestation day 6 through lactation day 21. There are no controlled data in human pregnancy.

AU TGA pregnancy category B3: Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. Studies in animals have shown evidence of an increased occurrence of fetal damage, the significance of which is considered uncertain in humans.

US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.

References

  1. "Product Information. Protonix (pantoprazole)." Wyeth-Ayerst Laboratories PROD (2001):
  2. "Product Information. Protonix IV (pantoprazole)." Wyeth-Ayerst Laboratories PROD
  3. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  4. Cerner Multum, Inc. "Australian Product Information." O 0

The following applies to the ingredients: Cyanocobalamin (found in Vitamin B12)

Professional Content

This drug should not be used during pregnancy unless the benefit outweighs the risk to the fetus. (AU)

AU TGA pregnancy category: Exempt
US FDA pregnancy category: C

Comments:
-Vitamin B12 needs are increased in pregnancy.
-Megaloblastic anemia of pregnancy is usually due to folic acid deficiency.
-Do not use for megaloblastic anemia of pregnancy due to folic acid deficiency.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. Cerner Multum, Inc. "Australian Product Information." O 0
  3. Allen LH "Multiple micronutrients in pregnancy and lactation: an overview." Am J Clin Nutr 81(S) (2005): 1206S-12S
  4. "Product Information. Cyanocobalamin (cyanocobalamin)." West Ward Pharmaceutical Corporation (2017):

Drug and Breastfeeding Interactions

The following applies to the ingredients: Pantoprazole

Professional Content

Use is not recommended and a decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother.

Excreted into human milk: Yes (oral); Unknown (parenteral)
Excreted into animal milk: Yes (parenteral)

Comment: The effects in the nursing infant are unknown.

Animal models have evidence of decreased pup weight at doses of at least 10 mg/kg/day. There have been reports of excretion into human breast milk.

References

  1. "Product Information. Protonix (pantoprazole)." Wyeth-Ayerst Laboratories PROD (2001):
  2. "Product Information. Protonix IV (pantoprazole)." Wyeth-Ayerst Laboratories PROD
  3. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  4. Cerner Multum, Inc. "Australian Product Information." O 0
  5. United States National Library of Medicine "Toxnet. Toxicology Data Network. http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT" (2013):
  6. Briggs GG, Freeman RK. "Drugs in Pregnancy and Lactation." Philadelphia, PA: Wolters Kluwer Health (2015):

The following applies to the ingredients: Cyanocobalamin (found in Vitamin B12)

Professional Content

Use is not recommended; benefit to mother should outweigh risk to the infant. (AU)

Excreted into human milk: Yes

Comments:
-Vitamin B12 needs are increased in lactation.
-Deficiency has been seen in breast fed children of vegetarian mothers, even with no symptoms of maternal deficiency.
-Four micrograms daily of B12 are recommended during lactation.

References

  1. Ehrlich A, Koch T, Amin B, et al. "Development and reliability testing of a standardized questionnaire to assess psoriasis phenotype." J Am Acad Dermatol 54 (2006): 987.e1-14
  2. Cerner Multum, Inc. "Australian Product Information." O 0
  3. "Product Information. Nascobal (cyanocobalamin)." Par Pharmaceutical Inc (2017):

Therapeutic Duplication Warnings

No warnings were found for your selected drugs.

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

Switch to: Professional Interactions

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.

Disclaimer: This content should not be considered complete and should not be used in place of a call or visit to a healthcare professional. Use of this content is subject to our terms of use & medical disclaimer.