Vitamin B12 + Esomeprazole
Esomeprazole brand name: Nexium.
We found no known interaction between Vitamin B12 and Esomeprazole in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Esomeprazole states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.
Vitamin B12 and Esomeprazole
We checked these two against our interaction database. Here is what we found.
No Known Interaction Found
We did not find a documented interaction between Esomeprazole and Vitamin B12 in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.
If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.
Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.
Vitamin B12 safety at a glance
Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.
Why No Interaction Is Listed for Esomeprazole
Interactions in our licensed database are recorded against drug classes, not just single drug names. Esomeprazole is filed under 6 classifications — including proton pump inhibitors (ppis), cytochrome p450 2c19 (cyp2c19) inhibitors, cytochrome p450 1a2 (cyp1a2) inducers. Vitamin B12 has documented interactions with 1 drug class — the most serious being metformin (glucophage) (minor) — and none of Esomeprazole’s classifications are among them.
Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.
Vitamin B12 Does Interact With Other Medications
Vitamin B12 has 20 minor known drug interactions in our database — Esomeprazole isn’t one of them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Vitamin B12
We haven’t checked that one against Vitamin B12 yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Vitamin B12. Pick one to open its full report.
Vitamin B12 in Pregnancy & Breastfeeding
When used orally in amounts that do not exceed the recommended dietary allowance (RDA). The RDA for vitamin B12 during pregnancy is 2.6 mcg daily. There is insufficient reliable information available about the safety of larger amounts of vitamin B12 during pregnancy.
When used orally in amounts that do not exceed the recommended dietary allowance (RDA). The RDA of vitamin B12 during lactation is 2.8 mcg daily. There is insufficient reliable information available about the safety of larger amounts of vitamin B12 while breastfeeding.
DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center
No Interaction — But Esomeprazole May Lower Your Vitamin B12 Levels
These two do not interact. The relationship runs the other way: the licensed record lists Esomeprazole as associated with lower Vitamin B12 levels — rated “Moderate Depletion”.
PPIs might reduce the absorption of vitamin B12, particularly with prolonged use. The reduced secretion of gastric acid and pepsin produced by PPIs can reduce absorption of protein-bound (dietary), but not supplemental, vitamin B12. This is because gastric acid is needed to release vitamin B12 from protein for absorption. Reduced vitamin B12 levels may be more common with PPIs than with H2-blockers, because they are more likely to produce achlorhydria. However, PPI therapy is unlikely to cause clinically significant vitamin B12 deficiency. Some evidence suggests that vitamin B12 deficiency is more likely in the case of prolonged PPI therapy (2 years or more) or insufficient dietary vitamin B12 intake. The odds of developing vitamin B12 deficiency are 65% higher in individuals taking PPIs for 2 years or more when compared with non-users. Also, vitamin B12 deficiency is more likely with prolonged, high-dose PPI therapy than with prolonged, low-dose therapy. Vitamin B12 deficiency is expected to diminish upon discontinuation of PPI therapy. The American College of Gastroenterology (ACG) does not recommend increased intake of vitamin B12 or routine monitoring of serum vitamin B12 levels for patients who are taking PPIs and have no other risk factors for vitamin B12 deficiency. For information on foods that are rich in vitamin B12, see our chart.
VITAMIN B12 — Moderate Depletion
See every medication linked to lower Vitamin B12 levels · See the full Esomeprazole nutrient report
Disclaimer: This checker finds which nutrients might be depleted by prescription or over-the-counter medications. Each nutrient depletion issue is rated based on clinical significance. Use your own professional judgment prior to making clinical decisions.© 2026 Therapeutic Research Center
Some Esomeprazole Products Have a Food Rule — Vitamin B12 Should Not Break It
At least one FDA label for a product containing Esomeprazole says to take it on an empty stomach. Most supplements — Vitamin B12 included — are taken with a meal, so the easy mistake is swallowing both together at breakfast. Where that rule applies, keep Esomeprazole on its own and move Vitamin B12 to a meal later in the day.
This may not be true of your version. Food instructions belong to the product, not the ingredient: two Esomeprazole products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.
Table 2: Recommended Dosage of Esomeprazole Magnesium Delayed-Release Capsules in Pediatric Patients by Indication Indication Patient Age Recommended Dosage Duration Healing of EE 12 years to 17 years Esomeprazole magnesium delayed-release capsules: 20 mg or 40 mg once daily 4 to 8 Weeks Treatment of Symptomatic GERD 12 years to 17 years Esomeprazole magnesium delayed-release capsules: 20 mg once
From the Dosage and Administration section of the FDA label we read for Esomeprazole — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›
A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.
Questions About Vitamin B12 or Esomeprazole
These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Vitamin B12 or Esomeprazole, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:
- Supplements for Leg Circulation Safe With Citalopram and Lisinopril ›
- Can You Take Xarelto And Nexium Together? ›
- Can You Take Zyrtec And Xyzal Together? ›
- Taking Nexium With Ibuprofen ›
Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.
See Every Supplement That Interacts With Esomeprazole
This page covers Vitamin B12 only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Esomeprazole page lists 154 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Adrafinil (moderate).
By severity: 3 major · 102 moderate · 49 minor.
From our pharmacist’s overview on the Esomeprazole page
“St. John's wort can lower the amount of esomeprazole (Nexium) in your blood by speeding up how the liver clears it, which can leave heartburn or ulcer treatment falling short.”
Reviewed by 2 · Jul 18, 2026
Taking Vitamin B12 as Part of a Dietary Supplement Product? Check It for Interactions
We hold 26,496 real supplement products containing Vitamin B12, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Vitamin B12. Even though Vitamin B12 itself has no known interaction with Esomeprazole, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:
Where Vitamin B12 and Esomeprazole Sit Against Everything Else
Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.
#7 of 1,452 supplements looked up here in the last 7 days
#450 of 2,830 medications looked up here in the last 7 days
Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.
Where does our data come from?
- Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
- Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Vitamin B12 reference on this page ↓
- Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Vitamin B12 and Esomeprazole records this page draws on were last updated July 11, 2026.
- What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
About Vitamin B12
What is Vitamin B12?
- Treating or preventing B12 deficiency
- Pernicious anemia
- Low energy and fatigue
- Nerve health and tingling/numbness
- Support for vegetarians and vegans
Vitamin B12 (cobalamin) is an essential nutrient your body needs to make red blood cells, keep nerves healthy, and support DNA. Supplements are very helpful for people who are deficient — such as vegans, older adults, and those with absorption problems — but taking extra B12 when you are not deficient is unlikely to boost energy or health. Talk to your pharmacist or doctor if you think you may be low.
Not applicable (a vitamin, not a plant part) · Tablets, capsules, sublingual (under-the-tongue) tablets, lozenges, liquid drops, nasal spray, and injections
An interaction check asks whether these two react with each other — it does not ask whether Vitamin B12 is a good idea for someone in your situation. Here is what our Vitamin B12 record says about it on its own.
Vitamin B12: dosing
The right amount of B12 depends on your age, diet, health, and whether you are deficient. Many daily supplements and multivitamins contain amounts well above the basic daily requirement, which is safe because excess is removed by the body.People who are deficient or who absorb B12 poorly sometimes need much higher doses or injections, which should be guided by a healthcare provider.
From our Vitamin B12 monograph — the full record covers uses, side effects and every documented interaction.
About Esomeprazole
What Is Esomeprazole Used For?
Brand name: Nexium
Esomeprazole treats problems caused by excess stomach acid. It's used to heal erosive esophagitis (damage to the esophagus from acid), control GERD (gastroesophageal reflux disease) symptoms like heartburn, and protect the stomach lining in people at risk for ulcers caused by NSAIDs (anti-inflammatory pain relievers like ibuprofen).
It's also used as part of a three-drug combination to wipe out H. pylori — a stomach bacteria linked to ulcers — and for people with rare conditions that cause the stomach to overproduce acid, such as Zollinger-Ellison syndrome.
Most-Reported Side Effects for Esomeprazole
From FAERS, the FDA’s public side-effect reporting system (235,235 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.
Other Drugs & Vitamin B12
Browse every other medication we’ve checked against Vitamin B12 — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
20 interactions
- Metformin ›
- Metformin Hydrochloride ›
- Metformin, Sitagliptin ›
- Alogliptin, Metformin ›
- Canagliflozin, Metformin ›
- Canagliflozin, Metformin Hydrochloride ›
- Dapagliflozin Propanediol, Metformin ›
- Dapagliflozin, Metformin Hydrochloride, Saxagliptin Hydrochloride ›
- Empagliflozin, Linagliptin, Metformin Hydrochloride ›
- Empagliflozin, Metformin ›
- Empagliflozin, Metformin Hydrochloride ›
- Ertugliflozin, Metformin Hydrochloride ›
- Glipizide, Metformin ›
- Glyburide, Metformin ›
- Linagliptin, Metformin Hydrochloride ›
- Metformin, Linagliptin ›
- Metformin, Rosiglitazone ›
- Pioglitazone, Metformin ›
- Saxagliptin, Metformin Xr ›
- Sitagliptin, Metformin ›
No interaction 2,809 drugs checked — show the list
We also checked Vitamin B12 against these medications and found no known interaction in our sources. Open any page to confirm.
- Apixaban ›
- Levothyroxine ›
- Amlodipine ›
- Methylphenidate ›
- Warfarin ›
- Sertraline ›
- Testosterone ›
- Losartan Potassium ›
- Metoprolol ›
- Aspirin ›
- Ivermectin ›
- Rivaroxaban ›
- Rosuvastatin ›
- Escitalopram ›
- Acetaminophen ›
- Tadalafil ›
- Clopidogrel ›
- Atorvastatin ›
- Docusate ›
- Valacyclovir ›
- Hydroxyurea ›
- Abemaciclib ›
- Ibuprofen ›
- Methamphetamine ›
- Sumatriptan ›
- Semaglutide ›
- Warfarin Sodium ›
- Tirzepatide ›
- Prednisone ›
- Propranolol ›
- Bupropion ›
- Lisdexamfetamine ›
- Amoxicillin ›
- Acyclovir ›
- Lisinopril ›
- Bendamustine ›
- Amitriptyline ›
- Doxycycline ›
- Methotrexate ›
- Fluoxetine ›
- Lamotrigine ›
- Amphetamine ›
- Gabapentin ›
- Pregabalin ›
- Acetaminophen, Codeine ›
- Azithromycin ›
- Dextroamphetamine ›
- Isotretinoin ›
- Clonazepam ›
- Omeprazole ›
- Quetiapine ›
- Methylene Blue ›
- Duloxetine ›
- Amlodipine Besylate ›
- Letrozole ›
- Buspirone ›
- Citalopram ›
- Naproxen ›
- Ciprofloxacin ›
- Bisoprolol ›
Showing the 60 most looked-up of 2,809 medications checked with no known interaction — see the full Vitamin B12 list.
Vitamin B12 References
The 30 references that drive our Vitamin B12 monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (2000). Washington, DC: National Academy Press, 2000. Available at: http://b
- Hartman TJ, Woodson K, Stolzenberg-Solomon R, et al. Association of the B-vitamins pyridoxal 5'-phosphate (B6), B12, and folate with lung cancer risk in older men. Am J Epidemiol 2001;153:688-94.. DOI
- Jansen T, Romiti R, Kreuter A, Altmeyer P. Rosacea fulminans triggered by high-dose vitamins B6 and B12. J Eur Acad Dermatol Venereol 2001;15:484-5..
- Lange H, Suryapranata H, De Luca G, et al. Folate therapy and in-stent restenosis after coronary stenting. N Engl J Med 2004;350:2673-81. PubMed
- Collin, S. M., Metcalfe, C., Refsum, H., Lewis, S. J., Zuccolo, L., Smith, G. D., Chen, L., Harris, R., Davis, M., Marsden, G., Johnston, C., Lane, J. A., Ebbing, M., Bonaa, K. H., Nygard, O., Ueland, P. M., Grau, M. V., Baron, J. A., Donovan, J. L., Nea
- Geissbuhler, P., Mermillod, B., and Rapin, C. H. Elevated serum vitamin B12 levels associated with CRP as a predictive factor of mortality in palliative care cancer patients: a prospective study over five years. J.Pain Symptom.Manage. 2000;20(2):93-103. PubMed
- Salles, N., Herrmann, F., Sakbani, K., Rapin, C. H., and Sieber, C. High vitamin B12 level: a strong predictor of mortality in elderly inpatients. J Am Geriatr.Soc 2005;53(5):917-918.
- Looker, H. C., Fagot-Campagna, A., Gunter, E. W., Pfeiffer, C. M., Sievers, M. L., Bennett, P. H., Nelson, R. G., Hanson, R. L., and Knowler, W. C. Homocysteine and vitamin B(12) concentrations and mortality rates in type 2 diabetes. Diabetes Metab Res R
- Uhl, W., Nolting, A., Golor, G., Rost, K. L., and Kovar, A. Safety of hydroxocobalamin in healthy volunteers in a randomized, placebo-controlled study. Clin Toxicol (Phila) 2006;44 Suppl 1:17-28. PubMed
- Borron, S. W., Baud, F. J., Barriot, P., Imbert, M., and Bismuth, C. Prospective study of hydroxocobalamin for acute cyanide poisoning in smoke inhalation. Ann Emerg.Med 2007;49(6):794-801, 801. PubMed
- Borron, S. W., Baud, F. J., Megarbane, B., and Bismuth, C. Hydroxocobalamin for severe acute cyanide poisoning by ingestion or inhalation. Am J Emerg.Med 2007;25(5):551-558. PubMed
- Lewis, J. G. Gout, Steatorrhoea, and Megaloblastic Anaemia. Ann Rheum.Dis 1962;21(3):284-286. PubMed
- Tal, S., Shavit, Y., Stern, F., and Malnick, S. Association between vitamin B12 levels and mortality in hospitalized older adults. J Am Geriatr.Soc 2010;58(3):523-526. PubMed
- Baztan, J. J., Gavidia, J. J., Gomez-Pavon, J., Esteve, A., and Ruiperez, I. High vitamin B12 levels and in-hospital mortality. J Am Geriatr.Soc 2010;58(11):2237-2238. PubMed
- Omboni, E., Checchini, M., and Longoni, F. [Hypopotassemia and megaloblastic anemia. Presentation of a case]. Minerva Med 8-31-1987;78(16):1255-1257.
- Aalfs As, Scholvinck LH, Horvath B. Acneiform eruption in a 5-year old due to vitamin B12 supplementation. Eur J Dermatol 2013;23(5):726-7. PubMed
- Balta I, Ozuguz P. Vitamin B12-induced acneiform eruption. Cutan Ocul Toxicol 2014;33(2):94-5. PubMed
- Carman KB, Belgemen T, Yis U. Involuntary movements misdiagnosed as seizure during vitamin B12 treatment. Pediatr Emerg Care 2013;29(11):1223-4. PubMed
- Djuric V, Bogic M, Popadic AP, et al. Anaphylactic reaction to hydroxycobalamin with tolerance to cyanocobalamin. Ann Allergy Asthma Immunol 2012;108(3):207-8. PubMed
- Kartel O, Gulec M, Demirel F, et al. Vitamin B12 allergy and successful desensitization with cyanocobalamin: A case report. Allergol Immunopath (Madr) 2012;40(5):324-5.
- Patiroglu T, Unal E, Yildirim S. Infantile tremor syndrome associated with cobalamin therapy: A case report. Clin Neurol Neurosurg 2013;115(9):1903-5. PubMed
- Schulte S, Barkema LW, Kardaun SH. Long-lasting atypical acneiform eruption with prominent comedones induced by hydroxocobalamin (vitamin B12). J Dtsch Dermatol Ges 2014;12(6):502-3.
- Zanus C, Alberini E, Costa P, et al. Involuntary movements after correction of vitamin B12 deficiency: A video-case report. Epileptic Disord 2012;14(2):174-80. PubMed
- Fanidi A, Carreras-Torres R, Larose TL, et al. Is high vitamin B12 status a cause of lung cancer? Int J Cancer. 2019 Sep 15;145(6):1499-1503. PubMed
- Fujita Y, Mizukami T, Maya Y, et al. Vitamin B12 allergy manifesting as lymphomatoid contact dermatitis. Eur J Dermatol. 2020;30(3):304-305. PubMed
- Dépret F, Hoffmann C, Daoud L, et al. Association between hydroxocobalamin administration and acute kidney injury after smoke inhalation: a multicenter retrospective study. Crit Care. 2019;23(1):421. PubMed
- Khairan P, Sobue T, Eshak ES, et al. Association of dietary intakes of vitamin B12, vitamin B6, folate, and methionine with the risk of esophageal cancer: the Japan Public Health Center-based (JPHC) prospective study. BMC Cancer 2021;21(1):982. PubMed
- Evans J, Pandya A, Ding Y, Qunibi WY. Hydroxocobalamin-Induced Oxalate Nephropathy in a Patient With Smoke Inhalation. Kidney Int Rep 2021;6(8):2228-2231. PubMed
- Lacombe V, Chabrun F, Lacout C, et al. Persistent elevation of plasma vitamin B12 is strongly associated with solid cancer. Sci Rep 2021;11(1):13361. PubMed
- Pegalajar-García MD, Cebolla-Verdugo M, Prados-Carmona Á, Llamas-Segura C, Navarro-Triviño FJ. Systemic allergic dermatitis to cobalt present in cyanocobalamin supplementation. Contact Dermatitis 2023;89(3):203-205. PubMed
Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.
Esomeprazole Is Linked to Lower Levels of 9 Nutrients
Natural Medicines records Esomeprazole as a medicine that can lower these. This is not an interaction with Vitamin B12 — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Read the full Esomeprazole nutrient depletion report ›
Vitamin B12 is itself a nutrient we track — see which medications may deplete VITAMIN B12.
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking Vitamin B12 and Esomeprazole Together: Common Questions
Is it safe to take Vitamin B12 with Esomeprazole?
Do Vitamin B12 and Esomeprazole have any of the same side effects?
Should I take Vitamin B12 and Esomeprazole at the same time of day?
Can Esomeprazole lower my Vitamin B12 levels?
How was the Vitamin B12 and Esomeprazole combination checked?
Does Vitamin B12 interact with any other medications?
Does Esomeprazole interact with any supplements?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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Still Have a Question About Esomeprazole and Vitamin B12?
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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.