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If a drug is given in solid form, then the drug must first break down into smaller particles (disintegration) and dissolve in the medium in which it is administered (dissolution) before it can traverse the cell membrane (permeation) and enter the bloodstream (absorption), Fig

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Accordingly, it has issued new advice to check vitamin B12 serum levels in patients being treated with metformin who have symptoms suggestive of vitamin B12 deficiency.[] The proposed mechanisms to explain metformin-induced vitamin B12 deficiency among patients with T2DM include alterations in small bowel motility, which stimulates bacterial overgrowth and consequential vitamin B12 deficiency, competitive inhibition or inactivation of vitamin B12 absorption, alterations in IF levels, and interaction with the cubulin endocytic receptor

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