التداخل بين ساكساغليبتين وميتفورمين وفيتامين ب12

Vitamin B 12 Deficiency In controlled clinical trials of metformin of 29-week duration, a decrease to subnormal levels of previously normal serum vitamin B 12 levels, 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, 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 saxagliptin and metformin hydrochloride extended-release tablets and manage any abnormalities [ see Adverse Reactions (6.1) ].