title: Drug-Induced Vitamin B12Deficiency: A Focus on Proton Pump Inhibitors and Histamine-2 Antagonists.
abstract: OBJECTIVE
  To review primary literature of gastric acid suppressive agents and vitamin B12deficiency.
  
  
  RESULTS
  From the published articles, proton pump inhibitors (PPIs) are associated with a higher risk of inducing vitamin B12deficiency than histamine-2 receptor antagonists (H2RAs). Literature suggests that there is an increased risk of developing vitamin B12deficiency in patients who are exposed to extended durations of therapy with PPIs. There are, however, some conflicting data in elderly patients suggesting that the PPI use for more than 3 years does not increase the risk of vitamin B12deficiency. No evidence was found to support the extended use of H2RA monotherapy causing vitamin B12deficiency. The inconsistency of results reported could be due to the differing patient populations studied, such as Zollinger-Ellison syndrome (ZES) and elderly patients. Overall, the lack of consistent evidence shows the need for more research in this area.
  
  
  CONCLUSIONS
  To investigate the clinical significance of vitamin B12deficiency caused by acid suppression with PPIs and H2RAs, longer prospective studies are needed. These studies should focus on patient-centered outcomes to accurately determine the extended usage of PPI and H2RA and the true effects on vitamin B12deficiency.
authors: 1 PGY-2 Psychiatric Pharmacy Residency, Charleston, SC, USA.
authors: Lauren
authors: L
authors: Linder
authors: 2 PGY-1 Pharmacy Practice Residency, Waco, TX, USA.
authors: Cynthia
authors: C
authors: Tamboue
authors: 3 Presbyterian College School of Pharmacy, Clinton, SC, USA.
authors: Jennifer N
authors: JN
authors: Clements
mesh_terms: D000367:Age Factors; D000818:Animals; D002986:Clinical Trials as Topic / Q000379:methods; D006635:Histamine H2 Antagonists / Q000009:adverse effects*; D006801:Humans; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D014806:Vitamin B 12 Deficiency / Q000139:chemically induced* / Q000175:diagnosis* / Q000453:epidemiology
chemical_list: D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors
keywords: gastric acid suppressive agents; histamine-2 receptor antagonist; proton pump inhibitor; vitamin B12 deficiency