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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) If you take any of these medications long-term, discuss B12 monitoring with your healthcare provider