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While omeprazole is useful for GERD and PUD, its use is not without the increased risk of other complications, such as an increased risk for aspiration pneumonia in certain patients, clinically relevant drug-drug interactions, and complications related to vitamin B12 deficiency, such as macrocytic anemia, hyperhomocysteinemia, and/or neuropathies.1-7 The focus of this article is related to the mechanism by which omeprazole could cause a deficiency in vitamin B12