التداخل بين ألوغليبتين وميتفورمين وفيتامين ب12

Vitamin B 12 Deficiency In metformin clinical trials of 29 week duration, a decrease to subnormal levels of previously normal serum vitamin B 12 levels was observed in approximately 7% of patients.

Such decrease, possibly due to interference with B 12 absorption from the B 12 -intrinsic factor complex, may be associated with anemia but appears to be rapidly reversible with discontinuation of metformin or vitamin B 12 supplementation.

Vitamin B 12 Deficiency: Metformin may lower vitamin B 12 levels.

Certain individuals (those with inadequate vitamin B 12 or calcium intake or absorption) appear to be predisposed to developing subnormal vitamin B 12 levels.

Measure hematologic parameters on an annual basis and vitamin B 12 at 2 to 3 year intervals in patients on alogliptin with metformin and manage any abnormalities [ see Adverse Reactions (6.1) ] .