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Long term prescription of medications such as the following are likely to increase the cause of, or exacerbate the risk of B12 deficiency - the proton pump inhibitors (esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole), famotidine, ranitidine, metformin, glibenclamide, gliclazide, glimepiride, glipizide, sodium valproate, gabapentin, doxycycline, some oral contraceptives

For people with absorption problems, injections are often more effective because they bypass the digestive system

[21] [22] This condition impairs B12 absorption in the terminal ileum and typically requires lifelong parenteral replacement therapy

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