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Therefore, maintaining adequate levels of this vitamin is essential for overall health and well-being

J Zhejiang Univ Sci B

Routine testing of vitamin B12 levels in metformin-treated patients should be considered. Because metformin often causes digestive tract upset, many patients are also put on a proton pump inhibitor (PPIs) such as esomeprazole ( Nexium ), lansoprazole ( Prevacid ) or omeprazole ( Prilosec )

Treatment with this drug should be administered with caution if the animal has chronic renal failure