Mebaal Drug Interactions

Antibiotics: The use of antibiotics may alter the intestinal microflora and may decrease the possible contribution of methylcobalamin by certain inhabitants of the microflora (eg, Lactobacillus spp) to the body's requirement for the vitamin. This may particularly be a problem for vegetarians. Garlic, onions, leeks, bananas, asparagus and artichokes, among other vegetables and fruits, contain inulins, which promote the growth of certain colonic bacteria, including Lactobacillus spp.
Cholestyramine: Cholestyramine may decrease the enterohepatic reabsorption of methylcobalamin.
Colchicine: Colchicine may cause decreased absorption of methylcobalamin.
Colestipol: Colestipol may decrease the enterohepatic reabsorption of methylcobalamin.
H₂ Blockers (Cimetidine, Famotidine, Nizatidine, Ranitidine): Chronic use of H₂ blockers may result in decreased absorption of methylcobalamin. They are unlikely to affect the absorption of supplemental B12.
Metformin: Metformin may decrease the absorption of methylcobalamin. This possible effect may be reversed with oral calcium supplementation.
Nitrous Oxide: Inhalation of the anaesthetic agent nitrous oxide (not to be confused with nitric oxide) can produce a functional deficiency. Nitrous oxide forms a complex with cobalt in methylcobalamin, the cofactor for methionine synthase, resulting in inactivation of the enzyme.
Para-Amino Salicylic Acid: Chronic use of the antituberculosis drug may decrease the absorption of methylcobalamin.
Potassium Chloride: It has been reported that potassium chloride may decrease the absorption in some.
Proton Pump Inhibitors: Chronic use of proton pump inhibitors may result in decreased absorption, naturally found in food sources.