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Its important to adjust treatment plans for these cases
Because neither compound is licensed in the UK, no formal pharmacokinetic or pharmacodynamic interaction studies have been conducted or reviewed by the MHRA
A recent analysis of the USFDA Adverse Event Reporting System revealed that patients taking both metformin and a PPI experienced significantly higher rates of hospitalizations and life-threatening complications related to B12 deficiency (such as severe neuropathy and cognitive decline) compared to those on monotherapy
includes warnings that parenteral thiamine may cause anaphylaxis and that the benzyl alcohol preservative is contraindicated in neonates due to risk of serious reactions)
For example, long-term use of oral contraceptives may lower levels of Vitamin B2 (riboflavin) , while some diabetes and epilepsy drugs affect Vitamin B12 (cobalamin) levels
