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These systemic effects are uncommon and typically mild

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Administered subcutaneously, its injectable form is rapidly absorbed and distributed to metabolically active tissues, where it specifically binds and inhibits NNMT catalytic activity without interfering with other enzymes in the nicotinamide pathway or NAD+ synthesis

99 B12 deficiency in infants can cause anaemia, abnormal skin and hair development, convulsions, failure to thrive, mental developmental delay and possibly abnormal movements, and direct supplementation of the infant is recommended in such cases