[127] [128] Synthesis [edit] Biosynthesis [edit] Vitamin B 12 is derived from a tetrapyrrolic structural framework created by the enzymes deaminase and cosynthetase which transform aminolevulinic acid via porphobilinogen and hydroxymethylbilane to uroporphyrinogen III
It also supports the creation of red blood cells and contributes to a healthy immune system
Patients should be advised about the urine discoloration (to avoid alarm) and counseled to report any persistent side effects
Interactions with drugs: Chloramphenicol can impede on the red blood cell producing properties of B12 Other drugs that decrease or reduce absorption of B12: antibiotics, cobalt irradiation, colchicine, colestipol, H2-blockers, metformin, nicotine, birth control pills, potassium chloride, proton pump inhibitors such as Prevacid, Losec, Aciphex, Pantaloc, and Zidovudine