Saxagliptin and metformin and Vitamin B12 interaction
Saxagliptin and metformin and Vitamin B12: the Saxagliptin and metformin prescribing label describes an interaction that usually calls for monitoring, a dose change, or spacing the doses.
Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.
What the FDA labels say
From the Saxagliptin and metformin label · effective 2026-08-21
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) ].
Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.
Open in the checkerNot 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.