[an error occurred while processing this directive] [an error occurred while processing this directive]

Answer to your Health Question

Question (10/25/2012):

Title: Interaction between B12 vitamin and Metoprolol, Ramipril and Bayer Aspirin.

I have been taking Metoprolol 25 mg and Ramipril 10 mg and Bayer 81 mg per day for over 8 years.

I have now been told I have Anemia and need B12 supplements.

Does taking these medications cause malabsorption of B12 in my body?

Thank you.

Jan

Answer:

Dear Jan,

Thank you very much for your question.

Ramipril is in a group of drugs called ACE inhibitors. ACE stands for angiotensin converting enzyme.

ACE inhibitors, have been associated with reduced absorption or reduced serum levels of vitamin B12.

In a study of people hospitalized with heart disease, those who had been taking aspirin were nearly twice as likely as nonusers to have a low or marginally low blood level of vitamin B12.

[Van Oijen MGH, Laheij RJF, Peters WHM, et al. Association of aspirin use with vitamin B12 deficiency (results of the BACH study). The American Journal of Cardiology 2004]

That finding by itself does not prove that taking aspirin causes vitamin B12 deficiency. However, aspirin is known to damage the stomach in some cases, and the stomach plays a key role in vitamin B12 absorption (by secreting hydrochloric acid and intrinsic factor).

Metoprolol is in a group of drugs called beta-blockers.

Some beta-adrenergic blockers (called "nonselective" beta blockers) decrease the uptake of potassium from the blood into the cells.

[Rosa RM, Silva P, Young JB, et al. Adrenergic modulation of extrarenal potassium disposal. The New England Journal of Medicine 1980]

[Lundborg P. The effect of adrenergic blockade on potassium concentrations in different conditions. Acta Medica Scandinavica 1983]

Potassium normalizes high blood pressure.

Drugs that have been associated with reduced absorption or reduced serum levels of vitamin B12 include ACE inhibitors, acetylsalicylic acid (aspirin), antibiotics, anticonvulsants, bile acid sequestrants, colchicine, H2 blockers, metformin, neomycin, nicotine, nitrous oxide, oral contraceptives, para-aminosalicylic acid, potassium chloride, proton pump inhibitors (PPIs), and zidovudine (AZT, Combivir®, Retrovir®).



Do you have any other questions? Enter your health question

[an error occurred while processing this directive]