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30 days (reconstituted) Mechanism Classification Primary Mechanism: NNMT (Nicotinamide N-methyltransferase) Inhibitor Target Enzyme: Nicotinamide N-methyltransferase Cellular Effect: Increases intracellular NAD+ and SAM levels Metabolic Pathway: NAD+ salvage pathway modulation Selectivity: Highly selective for NNMT (no cross-reactivity with related enzymes) Pharmacological Properties Route of Administration: Subcutaneous injection Bioavailability: High (subcutaneous)

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Understanding these mechanisms is essential for targeted investigation and management

Once used up, cyanocobalamin could theoretically cause cyanide toxicity particularly in those with kidney failure