Metformin and Vitamin B12 interaction

Metformin and Vitamin B12: the Metformin prescribing label describe an interaction that usually calls for monitoring, a dose change, or spacing the doses.

Moderate

Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.

What the FDA labels say

From the Metformin (Metformin hydrochloride) label · effective 2024-11-14

Moderate

Monitor hematological parameters annually and vitamin B 12 at 2 to 3 year intervals and manage any abnormalities.

Warnings and precautionsnames Vitamin B12View label on DailyMed
Moderate

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

Warnings and precautionsnames Vitamin B12View label on DailyMed
Moderate

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.

Warnings and precautionsnames Vitamin B12View label on DailyMed
Minor

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

Warnings and precautionsnames Vitamin B12View label on DailyMed
Minor

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

Warnings and precautionsnames Vitamin B12View label on DailyMed

Curated guidance for Vitamin B12

Minor

Metformin reduces B12 absorption; people on long-term metformin should have B12 levels checked periodically.

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.