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Cells characterized by rapid division (epithelial cells, bone marrow, myeloid cells) appear to have the greatest requirement for cyanocobalamin

Oxalate crystals have been observed in the urine of both healthy subjects given hydroxocobalamin and patients treated with hydroxocobalamin following suspected cyanide poisoning Product label: CYANOKIT (hydroxocobalamin) injection, powder, lyophilized, for solution [Meridian Medical Technologies, Inc.] Last revised: April 2011 [DailyMed] Hepatic Impairment (FDA) Cyanide poisoning: the safety and effectiveness of Cyanokit have not been studied in patients with hepatic impairment

This small molecule, known scientifically as 5-amino-1-methylquinolinium , works by blocking an enzyme called NNMT (nicotinamide N-methyltransferase), which plays a key role in fat storage

This conversion process is rate-limited by the enzymes NMNAT and NRK