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When a cell over-expresses NNMT, it does two costly things at once: it burns through methyl-donor capacity, and it diverts nicotinamide away from NAD+ regeneration into an inert metabolite (1-methylnicotinamide) that gets excreted

The FDA prescribing information does not mandate a gradual dose reduction protocol when stopping treatment

Compounded medications are not brand name or considered "generics" and are not represented to the patient as patented medications