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The most commonly reported side effects at therapeutic doses include mild nausea, particularly in the first week of a protocol, which typically resolves by day 7 to 10 without any dose adjustment
At that point, the NAMN ends up merging with the Preiss-Handler pathway to become NAD+ by the same means seen there
This is particularly relevant for patients receiving regular hydroxocobalamin injections for pernicious anaemia or malabsorption conditions
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