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There is some evidence that other vitamins and minerals, such as folic acid and copper, require the presence of stomach acid for optimal absorption. Long-term use of H-2 blockers may therefore promote a deficiency of these nutrients. Individuals requiring long-term use of H-2 blockers may therefore benefit from a multiple vitamin/mineral supplement.
Folic acid is needed by the body to utilize vitamin B12. Antacids, including nizatidine, inhibit folic acid absorption. However, folic acid supplementation can mask a vitamin B12 deficiency. Therefore, people taking antacids are advised to supplement with folic acid and vitamin B12.
Stomach acid may facilitate iron absorption. H-2 blocker drugs reduce stomach acid and are associated with decreased dietary iron absorption. People with ulcers may also be iron deficient due to blood loss and benefit from iron supplementation. Iron levels in the blood can be checked with lab tests.
Omeprazole, a drug closely related to lansoprazole, taken for seven days led to a near-total loss of stomach acid in healthy people and interfered with the absorption of a single administration of 120 mg of beta-carotene. It is unknown whether repeated administration of beta-carotene would overcome this problem or if absorption of carotenoids from food would be impaired. Persons taking omeprazole and related acid-blocking drugs for long periods may want to have carotenoid blood levels checked, eat plenty of fruits and vegetables, and consider supplementing with carotenoids.
Omeprazole, a drug closely related to lansoprazole, has interfered with the absorption of vitamin B12 from food (though not supplements) in some, but not all, studies. This interaction has not yet been reported with lansoprazole. However, a fall in vitamin B12 status may result from decreased stomach acid caused by acid blocking drugs, including lansoprazole.
In healthy people, a magnesium hydroxide/aluminum hydroxide antacid, taken with nizatidine, decreased nizatidine absorption by 12%. People can avoid this interaction by taking nizatidine two hours before or after any aluminum/magnesium-containing antacids. Some magnesium supplements such as magnesium hydroxide are also antacids.
Last Review: 03-24-2015
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