Drug & supplement interaction

Vitamin B12 + Grepafloxacin

Grepafloxacin brand name: Raxar.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Vitamin B12 and Grepafloxacin 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.

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Interaction report

Vitamin B12 and Grepafloxacin

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 Grepafloxacin 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

Vitamin B12 overall Generally safe B12 is generally very safe and has no established upper limit because excess is removed in the urine.
Pregnancy Likely Safe 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 insu... Read the full pregnancy detail
Breastfeeding Likely Safe 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 insuf... Read the full breastfeeding detail

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.

Still wondering about combining Grepafloxacin and Vitamin B12? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Grepafloxacin

Interactions in our licensed database are recorded against drug classes, not just single drug names. Grepafloxacin is filed under 7 classifications — including quinolone antibiotics, organic anion-transporting polypeptide substrates (oatp), qt interval-prolonging drugs. Vitamin B12 has documented interactions with 1 drug class — the most serious being metformin (glucophage) (minor) — and none of Grepafloxacin’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.

Keep it in perspective

Vitamin B12 Does Interact With Other Medications

Vitamin B12 has 20 minor known drug interactions in our database — Grepafloxacin isn’t one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Vitamin B12

Covers the 2,830 medications we’ve checked against Vitamin B12. Pick one to open its full report.

What to actually watch for

What Vitamin B12 Itself Has Been Linked To

This is not an interaction — nothing below involves Grepafloxacin. It is the side-effect record for Vitamin B12 on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Vitamin B12, this list is the first place to look. 6 entries are worth acting on rather than waiting out — marked below.

  • Trouble swallowing Worth acting on Additional detail

    “Intravenously, vitamin B12 (hydroxocobalamin) 2.5-10 grams can cause nausea and dysphagia.”

    Vitamin B12 · Natural Medicines adverse-effect record, reported in nausea and vomiting.

    1 source cited
    1. 82864. 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
  • Low potassium / Anemia Worth acting on Additional detail

    “According to case report data, the correction of megaloblastic anemia with vitamin B12 may result in fatal hypokalemia.”

    Vitamin B12 · Natural Medicines adverse-effect record, reported in anemia.

    1 source cited
    1. 82914. Omboni, E., Checchini, M., and Longoni, F. [Hypopotassemia and megaloblastic anemia. Presentation of a case]. Minerva Med 8-31-1987;78(16):1255-1257.
  • Seizures Worth acting on Additional detail

    “Treatment with vitamin B12 has been rarely associated with involuntary movements in infants with vitamin B12 deficiency. In some cases these adverse reactions were misdiagnosed as seizures or infantile tremor syndrome. These adverse reactions presented 2-5 days after treatment with vitamin B12 and resolved once vitamin B12 was discontinued.”

    Vitamin B12 · Natural Medicines adverse-effect record, reported in epilepsy.

    3 sources cited
    1. 90370. Carman KB, Belgemen T, Yis U. Involuntary movements misdiagnosed as seizure during vitamin B12 treatment. Pediatr Emerg Care 2013;29(11):1223-4. PubMed
    2. 90385. 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
    3. 90397. 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
  • Kidney problems Worth acting on Additional detail

    “There is a case report of oxalate nephropathy in a 54-year-old male which was determined to be related to the use of intravenous hydroxocobalamin as treatment for cyanide poisoning. Intermittent hemodialysis was started 5 days after admission, along with a low-oxalate diet, oral calcium acetate, and pyridoxine 5 mg/kg daily.”

    Vitamin B12 · Natural Medicines adverse-effect record, reported in myasthenia gravis.

    2 sources cited
    1. 107148. 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
    2. 107139. 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
  • Raised blood pressure Worth acting on Additional detail

    “In human clinical research, an intravenous loading dose of folic acid, vitamin B6, and vitamin B12, followed by daily oral administration after coronary stenting, increased restenosis rates. Hypertension following intravenous administration of hydroxocobalamin has been reported in human research.”

    Vitamin B12 · Natural Medicines adverse-effect record, reported in hypertension.

    3 sources cited
    1. 12150. 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
    2. 82870. 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
    3. 82864. 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
  • Hives / An allergic reaction Worth acting on Additional detail

    “Orally or intramuscularly, vitamin B12 can cause allergic reactions such as rash, pruritus, erythema, and urticaria. Theoretically, allergic reactions might be caused by the cobalt within the vitamin B12 molecule. In one case report, oral methylcobalamin resulted in contact dermatitis in a 59-year-old Japanese female with a cobalt allergy.”

    Vitamin B12 · Natural Medicines adverse-effect record, reported in allergic rhinitis (hay fever).

    6 sources cited
    1. 82864. 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
    2. 90373. 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
    3. 90381. 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.
    4. 103974. 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
    5. 114578. 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
    6. 90365. 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
  • Tremor or shakiness Additional detail

    Recorded for Vitamin B12 in the same Natural Medicines adverse-effect record shown under Seizures above.

  • Itching Additional detail

    Recorded for Vitamin B12 in the same Natural Medicines adverse-effect record shown under Hives / An allergic reaction above.

Showing the 10 most notable of 12 recorded effects — ranked by how unusual each one is across medicines generally, with serious effects weighted up.

Everything above comes from the Natural Medicines adverse-effect record for Vitamin B12 — expand a row for the licensed statement it rests on. We haven’t matched Grepafloxacin to its FDA label in our system yet, so we can’t compare its own side-effect list here — the leaflet that comes with your prescription is the authoritative list for Grepafloxacin.

Special populations

Vitamin B12 in Pregnancy & Breastfeeding

Pregnancy Likely Safe

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.

Lactation Likely Safe

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

Worth knowing

No Interaction — But Grepafloxacin May Lower Your Vitamin B12 Levels

These two do not interact. The relationship runs the other way: the licensed record lists Grepafloxacin as associated with lower Vitamin B12 levels — rated “Insignificant Depletion”.

Antibiotics might reduce the absorption of vitamin B12, but this effect is unlikely to be clinically significant. Disruption of the normal gastrointestinal (GI) flora may interrupt enterohepatic recirculation of vitamin B12 and increase fecal excretion. Vitamin B12 is also synthesized by the GI flora, but mainly in the colon where absorption is poor. The majority of bacterially-synthesized vitamin B12 is therefore excreted in the feces and does not significantly contribute to the body's store of vitamin B12. The effects of antibiotics on gastrointestinal bacteria are unlikely to have clinically significant effects on vitamin B12 levels. In people with bacterial overgrowth of the small bowel, antibiotics such as metronidazole (Flagyl) can actually improve vitamin B12 status. An increased bacterial load can bind significant amounts of vitamin B12 in the gut, preventing its absorption.

VITAMIN B12 — Insignificant Depletion

See every medication linked to lower Vitamin B12 levels · See the full Grepafloxacin 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

From our Q&A

Questions About Vitamin B12 or Grepafloxacin

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 Grepafloxacin, 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:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Grepafloxacin

This page covers Vitamin B12 only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Grepafloxacin page lists 164 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Apple (major), Arsenic (major) and Cesium (major).

By severity: 9 major · 113 moderate · 42 minor.

From our pharmacist’s overview on the Grepafloxacin page

“A week on grepafloxacin (Raxar), a quinolone antibiotic, often comes with juice at breakfast, coffee through the day, maybe a probiotic for the stomach, and each of those shows up on this list. The nine major entries among these 164 deserve your attention first: grapefruit and other fruit juices can block the transporter that carries t…”

Reviewed by 2 · Jul 18, 2026

Open the Grepafloxacin interaction page

One more smart check

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 Grepafloxacin, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Vitamin B12 and Grepafloxacin 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.

Supplement Vitamin B12
Top 10

#7 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Grepafloxacin
Steady interest

#2,447 of 2,830 medications looked up here in the last 7 days

29 days ago today

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 Grepafloxacin 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.
Data structure & sourcing designed and verified by .
Supplement

About Vitamin B12

What is Vitamin B12?

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.

Read the full Vitamin B12 monograph & all interactions
Keep checking

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.

0Major
0Moderate
20Minor
2,809No known interaction
Minor

20 interactions

No interaction 2,809 drugs checked — show the list
Evidence & sources

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.

  1. 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
  2. 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
  3. 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..
  4. 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
  5. 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
  6. 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
  7. 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.
  8. 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
  9. 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
  10. 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
  11. 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
  12. Lewis, J. G. Gout, Steatorrhoea, and Megaloblastic Anaemia. Ann Rheum.Dis 1962;21(3):284-286. PubMed
  13. 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
  14. 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
  15. Omboni, E., Checchini, M., and Longoni, F. [Hypopotassemia and megaloblastic anemia. Presentation of a case]. Minerva Med 8-31-1987;78(16):1255-1257.

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.

Pharmacist Counseling Corner

Taking Vitamin B12 and Grepafloxacin Together: Common Questions

Is it safe to take Vitamin B12 with Grepafloxacin?
We do not list a known interaction between Vitamin B12 and Grepafloxacin. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Can Grepafloxacin lower my Vitamin B12 levels?
Natural Medicines records Grepafloxacin as a medicine that can deplete Vitamin B12. That is the opposite direction to an interaction — it is a reason some people are told to take a supplement, not a reason to avoid one. Do not start one on the strength of this page; ask your pharmacist or doctor whether it applies to you.
How was the Vitamin B12 and Grepafloxacin combination checked?
Interactions in our licensed database are recorded against drug classes. Grepafloxacin is filed under 7 classifications, and Vitamin B12 has documented interactions with 1 drug class — none of Grepafloxacin's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Vitamin B12 interact with any other medications?
Yes. Vitamin B12 has 20 documented drug interactions in our database — Grepafloxacin is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Grepafloxacin interact with any supplements?
Yes. Grepafloxacin has documented interactions with 164 supplements in our database — Vitamin B12 is not one of them. The Grepafloxacin interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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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.