التداخل بين غليبيزيد وميتفورمين وفيتامين ب12

Vitamin B12 Levels: In controlled clinical trials with metformin of 29 weeks duration, a decrease to subnormal levels of previously normal serum vitamin B 12 , without clinical manifestations, was observed in approximately 7% of patients.

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

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

In these patients, routine serum vitamin B 12 measurements at 2 years to 3 years intervals may be useful.

While megaloblastic anemia has rarely been seen with metformin therapy, if this is suspected, vitamin B 12 deficiency should be excluded.