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Concurrent Use with Other NNMT Inhibitors or Methylation Modulators Combining with supplements or drugs that also inhibit NNMT or alter methylation (e.g., SAMe , niacin , methylfolate , resveratrol ) could lead to: Excess NAD accumulation Methyl donor depletion Unpredictable metabolic effects Use caution and monitor methylation-related pathways if stacking 3

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7 Similarly, in the CASTOR clinical trial, patients with relapsed or refractory multiple myeloma who received the combination of daratumumab with bortezomib and dexamethasone had significantly prolonged PFS relative to those who received bortezomib and dexamethasone alone

It is not available as a licensed medicine through the NHS or any regulated UK pharmacy