Proton pump inhibitors (PPIs) were associated with a higher risk of inducing vitamin B12 deficiency than histamine-2 receptor antagonists (H2RAs) but longer prospective studies are needed to confirm this finding, study authors concluded in the Journal of Pharmacy Practice.

Data from the review suggested that patients with extended exposure to PPIs have an increased risk of developing vitamin B12 deficiency. However, some data suggested that PPI use >3 years in elderly patients did not increase the risk of vitamin B12 deficiency

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No data supported that extended use of H2RA monotherapy caused vitamin B12 deficiency. Researchers described that the conflicting data reported may be due to differing patient populations studied (eg, elderly, Zollinger-Ellison syndrome). The lack of consistent data warrants additional research in this area. 

The authors concluded that more studies are needed to investigate the significance of vitamin B12 deficiency caused by acid suppression with PPIs and H2RAs. Future studies should include patient-centered outcomes to better determine the prolonged use of PPI and H2RA and their effects on vitamin B12 deficiency. 

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