Mebaal-500/Mebaal-1500 Drug Interactions

Antibiotics: The use of antibiotics may alter the intestinal microflora and may decrease the possible contribution of mecobalamin by certain inhabitants of the microflora (e.g. Lactobacillus species) 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 species.
Cholestyramine: Cholestyramine may decrease the enterohepatic reabsorption of mecobalamin.
Colchicine: Colchicine may cause decreased absorption of mecobalamin.
Colestipol: Colestipol may decrease the enterohepatic reabsorption of mecobalamin.
H₂ Blockers (cimetidine, famotidine, nizatidine, ranitidine): Chronic use of H₂ blockers may result to decreased absorption of mecobalamin. They are unlikely to affect the absorption of supplemental B₁₂.
Metformin: Metformin may decrease the absorption of mecobalamin. This possible effect may be reversed with oral calcium supplementation.
Nitrous Oxide: Inhalation of the anesthetic agent nitrous oxide (not to be confused with nitric oxide) can produce a functional deficiency. Nitrous oxide forms a complex with cobalt in mecobalamin, the cofactor for methionine synthase, resulting in inactivation of the enzyme.
Para-amino Salicylic Acid: Chronic use of the anti-tuberculosis drug may decrease the absorption of mecobalamin.
Potassium chloride: It has been reported that potassium chloride may decrease the absorption of mecobalamin.
Proton Pump Inhibitors (lansoprazole, omeprazole, pantoprazole, rabeprazole): Chronic use of proton pump inhibitors may result in decreased absorption, naturally found in food sources.