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Potential interactions include: Metformin (used for type 2 diabetes) Proton pump inhibitors (PPIs) and H2-receptor antagonists (used for acid reflux) Colchicine (used for gout) Nitrous oxide (anaesthetic gas that can inactivate B12) Chloramphenicol (may reduce the haematological response to B12 therapy) [14] If you take any of these medications long-term, discuss B12 monitoring with your healthcare provider