Vitamin B-12 250 mcg Ingredients & Drug Interactions
by Major
What is this page for?
First and foremost: checking Vitamin B-12 250 mcg against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.
Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy
Vitamin B-12 250 mcg is a dietary supplement by Major with 3 active ingredients. Its ingredients are commonly taken for treating or preventing b12 deficiency, pernicious anemia, low energy and fatigue.Based on those ingredients, 188 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Calcium, Vitamin B12. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Vitamin B-12 250 mcg by Major
Ask about any prescription or over-the-counter medication and we check it for interactions with Vitamin B-12 250 mcg by Major — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Vitamin B-12 250 mcg by Major
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
This tablet contains 3 active ingredients: vitamin B12, calcium, and phosphorus. Vitamin B12 is an essential nutrient your body uses for nerve function, red blood cell formation, and DNA synthesis.
Calcium supports bone health and is involved in muscle and nerve function. The product also includes standard inactive ingredients — microcrystalline cellulose, croscarmellose sodium, stearic acid, silica, and magnesium stearate — which help form and stabilize the tablet.
Does it work?
Strong evidence
Vitamin B12 is effective for treating B12 deficiency and Imerslund-Grasbeck disease (a rare inherited condition affecting B12 absorption). It's also likely effective for cyanide poisoning and possibly effective for canker sores and postherpetic neuralgia (nerve pain after shingles).
Calcium is effective for treating low blood calcium (hypocalcemia), high potassium (hyperkalemia), and indigestion, and likely effective for osteoporosis prevention. We hold no effectiveness data for phosphorus in this product.
How safe is it?
Well-documented data
Vitamin B12 is generally very safe — your body excretes excess B12 in the urine, and there's no established upper limit. It's safe at recommended amounts during pregnancy and breastfeeding, where it's actually needed.
Orally, B12 is well-tolerated; serious side effects are rare, though allergic reactions such as rash or hives are possible, and in very rare cases, correcting certain types of anemia with B12 has been linked to severe low potassium (hypokalemia). Calcium is generally well-tolerated at recommended doses, though higher amounts can cause problems.
Common side effects include belching, constipation, diarrhea, and stomach upset. High doses (over 1500 mg daily) may raise concerns about prostate cancer risk and cardiovascular disease risk, though research on these links is mixed and debated.
Calcium is safe at recommended amounts in pregnancy and breastfeeding.
Meds to double-check
Major interaction found
Before you start, check with your pharmacist if you take dolutegravir or elvitegravir (HIV drugs), ceftriaxone (antibiotic — especially by IV), levothyroxine (thyroid), sotalol (blood pressure), metformin (diabetes), raltegravir (HIV), diltiazem (heart), or calcipotriene (psoriasis). The interactions are serious enough that timing or avoiding the supplement may be necessary.
The bottom line
Scorecard at a glanceFully disclosed formula with clinical evidence supporting its stated purpose. Major medication interactions have been identified, and safety information is well characterized.
This B-12 supplement works well if you have a deficiency or certain conditions like Imerslund-Grasbeck disease. The calcium adds a bone-health component, but if you take HIV medications, thyroid medication, blood pressure drugs, or the antibiotic ceftriaxone intravenously, you'll need to space your doses carefully or avoid this product.
Talk to your pharmacist about whether your current medications will work with this supplement.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 2 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Apr 25, 2019.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Vitamin B-12 250 mcg, straight from the product label.
| Brand | Major |
|---|---|
| Barcode (UPC) | 309044218137 |
| Net contents | 130 Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Apr 25, 2019 |
| DSLD ID | 201745 |
| Product type | Other Combinations |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | Nutrient, All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Dairy Free, Sugar Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Vitamin B-12 250 mcg by Major, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Vitamin B12 | 250 mcg | 10417% |
| Calcium | 40 mg | 3% |
| Phosphorus | 30 mg | 2% |
Other ingredients: Microcrystalline Cellulose, Croscarmellose Sodium, Stearic Acid, Silica, Magnesium Stearate
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements
Re-Order No. 700078 Potency guaranteed Contributes to the health of the nervous system
FDA Statement of Identity
Dietary Supplement
Suggested/Recommended/Usage/Directions
Directions: For adults, take one (1) tablet daily, preferably with a meal.
Precautions
As a reminder, discuss the supplements and medications you take with your health care providers.
AS with any supplement, if you are pregnant, nursing, taking medication or have a medical condition, consult your physician before use.
Discontinue use and consult your physician if any adverse reactions occur.
Keep out of reach of children.
Tamper resistant: Do not use if clear neck seal is broken or missing.
Formulation
Free of: Yeast, wheat, milk or milk derivatives, lactose, sugar, preservatives, soy, artificial color, artificial flavor, sodium (less than 5 mg per serving).
Formula
Vitamin B-12 contributes to the health of the nervous system. Vitamin B-12 is essential for normal formation of blood cells.
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
Storage
Store at room temperature in a dry place.
General
Prod. No. 700078 M-95 Rev. 05/17
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Vitamin B-12 250 mcg by Major label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in Vitamin B-12 250 mcg by Major
These are the 3 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Tablet(s) Dosage formTablet Or Pill Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Vitamin B12
Interacts with20 drugs
Vitamin B12 (cobalamin) is an essential nutrient your body needs to make red blood cells, keep nerves healthy, and support DNA. Supplements are very h...
Vitamin B12 monograph & interactionsCalcium
Interacts with168 drugs
Calcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet f...
Calcium monograph & interactionsPhosphorus
Other (inactive) ingredients: Microcrystalline Cellulose, Croscarmellose Sodium, Stearic Acid, Silica, Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.
Vitamin B-12 250 mcg by Major Drug Interactions
HelloPharmacist Interaction Report
Major Vitamin B-12 250 mcg by Major contains calcium, which interacts with a number of medications.
The most serious concern is with HIV integrase inhibitors — dolutegravir (Tivicay) and elvitegravir (Vitekta) — where calcium can reduce drug levels by a significant amount. If you take either of these, separate your doses by at least 2 hours before or 6 hours after calcium (2 hours after for elvitegravir).
Read the full breakdown — every affected drug type, severity by severity
Calcium also has major interactions with the antibiotic ceftriaxone (Rocephin) when given intravenously; the two can form a dangerous precipitate in your lungs and kidneys, so avoid taking intravenous calcium within 48 hours of this antibiotic. At moderate severity, calcium reduces absorption of the thyroid medication levothyroxine (Synthroid) and the blood pressure drug sotalol (Betapace) — space these doses 4 or more hours apart from calcium.
Calcium may also reduce effectiveness of the heart medication diltiazem (Cardizem) and the HIV drug raltegravir (Isentress), and theoretically increase the risk of high blood calcium (hypercalcemia) if you're using the psoriasis medication calcipotriene (Dovonex).
Vitamin B12 has a minor interaction with metformin (Glucophage), the common diabetes medication, which can interfere with B12 absorption over time. We could not check phosphorus — we hold no data for it.
Altogether, these interactions span 186 individual medications. Use the medication checker on this page to look up your exact prescriptions before you start.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Vitamin B-12 250 mcg?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Vitamin B-12 250 mcg interact with 188 drugs. Click any drug to see the details.
2 of the 3 ingredients in Vitamin B-12 250 mcg interact with drugs. Each result below shows which ingredient is responsible. Calcium Vitamin B12
CeftriaxoneRocephin
How Ceftriaxone interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumCeftriaxone (rocephin) Major
Interaction Summary
Co-administration of intravenous calcium and ceftriaxone can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys.
Read the full Calcium + Ceftriaxone interactionCobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide FumarateGenvoya
How Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumElvitegravir (vitekta), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Calcium + Cobicistat, Elvitegravir, Emtricitabine, Tenofovir Alafenamide Fumarate interactionDolutegravirTivicay
How Dolutegravir interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumDolutegravir (tivicay) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Calcium + Dolutegravir interactionDolutegravir, Emtricitabine, Tenofovir AlafenamideDolutegravir, Emtricitabine, Tenofovir Alafenamide
How Dolutegravir, Emtricitabine, Tenofovir Alafenamide interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumDolutegravir (tivicay), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Calcium + Dolutegravir, Emtricitabine, Tenofovir Alafenamide interactionDolutegravir, RilpivirineJuluca
How Dolutegravir, Rilpivirine interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumDolutegravir (tivicay) Major
Interaction Summary
Calcium seems to reduce levels of dolutegravir.
Read the full Calcium + Dolutegravir, Rilpivirine interactionElvitegravirVitekta
How Elvitegravir interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumElvitegravir (vitekta) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Calcium + Elvitegravir interactionElvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil FumarateStribild
How Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumElvitegravir (vitekta), Bictegravir/emtricitabine/tenofovir Alafenamide (biktarvy) Major
Interaction Summary
Calcium seems to reduce levels of elvitegravir.
Read the full Calcium + Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate interactionAlendronateBinosto, Fosamax
How Alendronate interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumBisphosphonates Moderate
Interaction Summary
Calcium reduces the absorption of bisphosphonates.
Read the full Calcium + Alendronate interactionAlendronate Sodium
How Alendronate Sodium interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumBisphosphonates Moderate
Interaction Summary
Calcium reduces the absorption of bisphosphonates.
Read the full Calcium + Alendronate Sodium interactionAlendronate Sodium, CholecalciferolFosamax Plus D
How Alendronate Sodium, Cholecalciferol interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumBisphosphonates Moderate
Interaction Summary
Calcium reduces the absorption of bisphosphonates.
Read the full Calcium + Alendronate Sodium, Cholecalciferol interactionAlginic Acid, Aluminum HydroxideRafton
How Alginic Acid, Aluminum Hydroxide interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Alginic Acid, Aluminum Hydroxide interactionAluminum Acetate, Benzethonium ChlorideBuro-Sol Otic Solution
How Aluminum Acetate, Benzethonium Chloride interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Acetate, Benzethonium Chloride interactionAluminum ChlorideAluminum Chloride, Anhydrol Forte, Driclor, Drysol
How Aluminum Chloride interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Chloride interactionAluminum HydroxideAlu-Cap, Amphojel, Gaviscon
How Aluminum Hydroxide interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Hydroxide interactionAluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
How Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interactionAluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin
How Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interactionAluminum Hydroxide, Magnesium Hydroxide (otc Drug)Maalox, Mucogel
How Aluminum Hydroxide, Magnesium Hydroxide (otc Drug) interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Hydroxide, Magnesium Hydroxide (otc Drug) interactionAluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug)Mylanta
How Aluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug) interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum Hydroxide, Magnesium Hydroxide, Simethicone (otc Drug) interactionAluminum, CalciumDomeboro
How Aluminum, Calcium interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum, Calcium interactionAluminum, Magnesium (otc Drug)Almagel
How Aluminum, Magnesium (otc Drug) interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum, Magnesium (otc Drug) interactionAluminum, Magnesium Hydroxide (otc Drug)Wingel
How Aluminum, Magnesium Hydroxide (otc Drug) interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aluminum, Magnesium Hydroxide (otc Drug) interactionAmiloride, HydrochlorothiazideAmil-Co, Amilzide, Moduret 25, Moduretic
How Amiloride, Hydrochlorothiazide interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Amiloride, Hydrochlorothiazide interactionAmphotericin, TetracyclineMysteclin-F
How Amphotericin, Tetracycline interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumTetracycline Antibiotics Moderate
Interaction Summary
Calcium seems to reduce the absorption of tetracycline antibiotics.
Read the full Calcium + Amphotericin, Tetracycline interactionAspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #3
How Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumAluminum Moderate
Interaction Summary
Calcium citrate might increase aluminum absorption and toxicity.
Read the full Calcium + Aspirin, Aluminum Hydroxide, Codeine Phosphate, Magnesium Hydroxide interactionAtenolol, ChlortalidoneAtenixCo, Tenoret 50, Totaretic
How Atenolol, Chlortalidone interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Atenolol, Chlortalidone interactionAtenolol, ChlorthalidoneTenoretic
How Atenolol, Chlorthalidone interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Atenolol, Chlorthalidone interactionAzilsartan, ChlorthalidoneEdarbyclor
How Azilsartan, Chlorthalidone interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Azilsartan, Chlorthalidone interactionBenazepril, HydrochlorothiazideLotensin HCT
How Benazepril, Hydrochlorothiazide interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Benazepril, Hydrochlorothiazide interactionBendroflumethiazideAprinox, Naturetin, Neo-NaClex
How Bendroflumethiazide interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Bendroflumethiazide interactionBendroflumethiazide, NadololCorzide
How Bendroflumethiazide, Nadolol interacts with Vitamin B-12 250 mcg — through 1 ingredient. Tap an ingredient for the detail:
CalciumThiazide Diuretics Moderate
Interaction Summary
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Read the full Calcium + Bendroflumethiazide, Nadolol interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Vitamin B-12 250 mcg with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Calcium
Ceftriaxone (Rocephin)
Co-administration of intravenous calcium and ceftriaxone can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys.
Avoid administering intravenous calcium in any form, such as parenteral nutrition or Lactated Ringers, within 48 hours of intravenous ceftriaxone. Case reports in neonates show that administering intravenous ceftriaxone and calcium can result in precipitation of a ceftriaxone-calcium salt in the lungs and kidneys. In several cases, neonates have died as a result of this interaction. So far there are no reports in adults; however, there is still concern that this interaction might occur in adults.
Dolutegravir (Tivicay)
Calcium seems to reduce levels of dolutegravir.
Advise patients to take dolutegravir either 2 hours before or 6 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium carbonate 1200 mg concomitantly with dolutegravir 50 mg reduces plasma levels of dolutegravir by almost 40%. Calcium appears to decrease levels of dolutegravir through chelation.
Elvitegravir (Vitekta)
Calcium seems to reduce levels of elvitegravir.
Advise patients to take elvitegravir either 2 hours before or 2 hours after taking calcium supplements. Pharmacokinetic research suggests that taking calcium along with elvitegravir can reduce blood levels of elvitegravir through chelation.
Aluminum
Calcium citrate might increase aluminum absorption and toxicity. Other types of calcium do not increase aluminum absorption.
Calcium citrate can increase the absorption of aluminum when taken with aluminum hydroxide. The increase in aluminum levels may become toxic, particularly in individuals with kidney disease. However, the effect of calcium citrate on aluminum absorption is due to the citrate anion rather than calcium cation. Calcium acetate does not appear to increase aluminum absorption.
Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)
Calcium might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide and calcium can be taken together if taken with food. However, if taken on an empty stomach, bictegravir/emtricitabine/tenofovir alafenamide should not be taken with, or 2 hours after, calcium containing products.
Bisphosphonates
Calcium reduces the absorption of bisphosphonates.
Advise patients to take bisphosphonates at least 30 minutes before calcium, but preferably at a different time of day. Calcium supplements decrease absorption of bisphosphonates.
Calcipotriene (Dovonex)
Taking calcipotriene with calcium might increase the risk for hypercalcemia.
Calcipotriene is a vitamin D analog used topically for psoriasis. It can be absorbed in sufficient amounts to cause systemic effects, including hypercalcemia. Theoretically, combining calcipotriene with calcium supplements might increase the risk of hypercalcemia.
Digoxin (Lanoxin)
Using intravenous calcium with digoxin might increase the risk of fatal cardiac arrhythmias.
Hypercalcemia increases the risk of fatal cardiac arrhythmias with digoxin. However, one retrospective analysis of clinical data suggests that intravenous calcium does not increase the risk of dysrhythmias or mortality in patients receiving digoxin.
Diltiazem (Cardizem, Others)
Theoretically, calcium may reduce the therapeutic effects of diltiazem.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, calcium might increase this risk of hypercalcemia and reduce the effectiveness of diltiazem.
Levothyroxine (Synthroid, Others)
Calcium seems to reduce the absorption and effectiveness of levothyroxine.
Advise patients to take levothyroxine and calcium supplements at least 4 hours apart. Calcium reduces levothyroxine absorption, probably by forming insoluble complexes. Calcium carbonate supplements reduce effectiveness of levothyroxine in patients with hypothyroidism.
Lithium
Theoretically, concomitant use of calcium and lithium may increase this risk of hypercalcemia.
Clinical research suggests that long-term use of lithium may cause hypercalcemia in 10% to 60% of patients. Theoretically, concomitant use of lithium and calcium supplements may further increase this risk.
Quinolone Antibiotics
Calcium seems to reduce the absorption of quinolone antibiotics.
Advise patients to take oral quinolones at least 2 hours before or 4-6 hours after calcium supplements or calcium-fortified foods. Taking calcium at the same time as oral quinolones can reduce quinolone absorption. Calcium binds to quinolones in the gut.
Raltegravir (Isentress)
Calcium may reduce levels of raltegravir.
Pharmacokinetic research shows that taking a single dose of calcium carbonate 3000 mg along with raltegravir 400 mg twice daily modestly decreases the mean area under the curve of raltegravir, but the decrease does not necessitate a dose adjustment of raltegravir. However, a case of elevated HIV-1 RNA levels and documented resistance to raltegravir has been reported for a patient taking calcium carbonate 1 gram three times daily plus vitamin D3 (cholecalciferol) 400 IU three times daily in combination with raltegravir 400 mg twice daily for 11 months. It is thought that calcium reduced raltegravir levels by chelation, leading to treatment failure.
Sotalol (Betapace)
Calcium seems to reduce the absorption of sotalol.
Advise patients to separate doses by at least 2 hours before or 4-6 hours after calcium. Calcium appears to reduce the absorption of sotalol, probably by forming insoluble complexes.
Tetracycline Antibiotics
Calcium seems to reduce the absorption of tetracycline antibiotics.
Advise patients to take oral tetracyclines at least 2 hours before, or 4-6 hours after calcium supplements. Taking calcium at the same time as oral tetracyclines can reduce tetracycline absorption. Calcium binds to tetracyclines in the gut.
Thiazide Diuretics
Taking calcium along with thiazides might increase the risk of hypercalcemia and renal failure.
Thiazides reduce calcium excretion by the kidneys. Using thiazides along with moderately large amounts of calcium carbonate increases the risk of milk-alkali syndrome (hypercalcemia, metabolic alkalosis, renal failure). Patients may need to have their serum calcium levels and/or parathyroid function monitored regularly.
Verapamil (Calan, Others)
Theoretically, calcium may reduce the therapeutic effects of verapamil.
Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically, use of calcium supplements may increase this risk of hypercalcemia and reduce the effectiveness of verapamil.
Calcium Channel Blockers
Intravenous calcium may decrease the effects of calcium channel blockers; oral calcium is unlikely to have this effect.
Intravenous calcium is used to decrease the effects of calcium channel blockers in the management of overdose. Intravenous calcium gluconate has been used before intravenous verapamil (Isoptin) to prevent or reduce the hypotensive effects without affecting the antiarrhythmic effects. But there is no evidence that dietary or supplemental calcium when taken orally interacts with calcium channel blockers.
Vitamin B12
Metformin (Glucophage)
Metformin, a common medication used to manage type 2 diabetes, has been associated with lower vitamin B12 levels in some individuals. Prolonged use of metformin can interfere with the absorption of B12 in the digestive system, potentially leading to a deficiency in this essential vitamin.
Brand information
Manufacturer and brand details for Vitamin B-12 250 mcg, from the product label.
Major
See all Major products- Name
- Major Pharmaceuticals
- Street Address
- 17177 N Laurel Park Drive, Suite 233
- City
- Livonia
- State
- MI
- ZipCode
- 48152
- Phone Number
- (800) 616-2471
Vitamin B-12 250 mcg by Major: Common Questions
Does Vitamin B-12 250 mcg by Major interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Can I take this if I'm on metformin for diabetes?
Does this product have a lot of fillers?
Is B12 safe to take if I'm pregnant?
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The Full Monographs Behind Vitamin B-12 250 mcg’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Vitamin B12
Interacts with 20 drugsVitamin 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 — su...
Read the full Vitamin B12 monograph → Herb & supplement monographCalcium
Interacts with 168 drugsCalcium is an essential mineral your body needs for strong bones, nerve signaling, and muscle function, and supplements can help fill gaps when diet falls short. Most people do best getting...
Read the full Calcium monograph →Sources & How We Checked
Vitamin B-12 250 mcg's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 92 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Vitamin B12 30 references
- 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
Calcium 62 references
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- Saunders D, Sillery J, Chapman R. Effect of calcium carbonate and aluminum hydroxide on human intestinal function. Dig Dis Sci 1988;33:409-13. PubMed
- Friedman PA, Bushinsky DA. Diuretic effects on calcium metabolism. Semin Nephrol 1999;19:551-6.
- Koo WK, Walters JC, Esterlitz J, et al. Maternal calcium supplementation and fetal bone mineralization. Obstet Gynecol 1999;94:577-82. DOI
- Raman L, Rajalakshmi K, Krishnamachari KAVR, et al. Effect of calcium supplementation to undernourished mothers during pregnancy on the bone density of the neonates. Am J Clin Nutr 1978; 31:466-9. DOI
- Murry JJ, Healy MD. Drug-mineral interactions: a new responsibility for the hospital dietician. J Am Diet Assoc 1991;91:66-73.
- Chan JM, Giovannucci E, Andersson SO, et al. Dairy products, calcium, phosphorous, vitamin D, and risk of prostate cancer. Cancer Causes Control 1998;9:559-66.
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- Moser LR, Smythe MA, Tisdale JE. The use of calcium salts in the prevention and management of verapamil-induced hypotension. Ann Pharmacother 2000;34:622-9. PubMed
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- Pletz MW, Petzold P, Allen A, et al. Effect of calcium carbonate on bioavailability of orally administered gemifloxacin. Antimicrob Agents Chemother 2003;47:2158-60.. PubMed
- Bar-Or D, Yoel G. Calcium and calciferol antagonize effect of verapamil in atrial fibrillation. Br Med J 1981;282:1585-6.
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- Bourke JF, Mumford R, Whittaker P, et al. The effects of topical calcipotriol on systemic calcium homeostasis in patients with chronic plaque psoriasis. J Am Acad Dermatol 1997;37:929-34.
- Gueguen L, Pointillart A. The bioavailability of dietary calcium. J Am Coll Nutr 2000;19:119s-136s. PubMed
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- Tseng M, Breslow RA, Graubard BI, Ziegler RG. Dairy, calcium, and vitamin D intakes and prostate cancer risk in the National Health and Nutrition Examination Epidemiologic Follow-up Study cohort. Am J Clin Nutr 2005;81:1147-54. PubMed
- Weingarten MA, Zalmanovici A, Yaphe J. Dietary calcium supplementation for preventing colorectal cancer and adenomatous polyps. Cochrane Database Syst Rev 2004;(1):CD003548. PubMed
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- Rocephin (ceftriaxone) and calcium interaction. Pharmacist's Letter / Prescriber's Letter 2007;23(10):231005.
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- Neuhofel, A. L., Wilton, J. H., Victory, J. M., Hejmanowsk, L. G., and Amsden, G. W. Lack of bioequivalence of ciprofloxacin when administered with calcium-fortified orange juice: a new twist on an old interaction. J Clin Pharmacol. 2002;42(4):461-466. DOI
- Dickinson, H. O., Nicolson, D. J., Cook, J. V., Campbell, F., Beyer, F. R., Ford, G. A., and Mason, J. Calcium supplementation for the management of primary hypertension in adults. Cochrane.Database.Syst.Rev. 2006;(2):CD004639. PubMed
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Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC