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Hydroxocobalamin might also work less well if you're also taking medications that lower blood cell production, like chloramphenicol

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Due to the compounds plasma half-life of approximately 3.86.9 hours [4] , twice-daily (BID) dosing may provide more sustained NNMT inhibition

and c) irregular dietary patterns), reduced bioavailability (impairment of the intrinsic factor-mediated absorption pathway, often due to the widespread and prolonged use of proton pump inhibitors), and malabsorption syndromes

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