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Any cloudiness, particles, or color change means it's degraded

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Interactions with medications Some medications can interfere with vitamin B12 malabsorption: Metformin Medication for reflux eg Omeprazole (Losec), Pantoprazole (Somac), Esomprazole (Nexium) Cimetidine and Ranitidine Neomycin If youre starting metformin or youve been taking it and still feel unsure about it Dr Sultan has created this clear, practical guide to help you understand what its doing and what to expect