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Patients should avoid ingesting large amounts of vitamin C within 1 hour of oral vitamin B12 administration • Extended release potassium products • Antibiotics such as gentamicin, neomycin, tobramycin • Anti-seizure medications such as phenobarbital, phenytoin, primidone • Medicines used to treat heartburn like H2 blockers such as cimetidine and proton pump inhibitors such as omeprazole • Antacids such as ranitidine, cimetidine Vitamin B12 Injection Storage and Safety Information Vitamin B12 tablets should be in a cool and dry place

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The reduction in the concentration of oxidative enzymes in lower extremity muscles has been suggested to be the reason for this early lactic acidosis (51)