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Permanent nerve damage will occur if vitamin B12 deficiency has has gone without treatment for a sufficient time A couple days: Aciphex / rabeprazole is a proton pump inhibitor: these drugs bind to an enzyme (proton pump) located on stomach parietal cells and block the production of hydrogen ions. Tell your doctor if you have symptoms of low vitamin B-12 levels, including shortness of breath, lightheadedness, irregular heartbeat, muscle weakness, pale skin, feeling tired, mood changes, and tingling or numbness in the arms and legs Aciphex can be taken with or without food. So then the hydrogen ions can't combine with chloride ions to form gastric /stomach acid Learn how much sleep you need. I have bad stomach pains, diarrhea, nausea You should check with your doctor to see when the best time for you to take your Aciphex would be. AcipHex may also be used for other purposes not listed in this medication guide. 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