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Using a combined COMT-I/LDopa treatment in PD patients has also shown to be effective in lowering Hcy levels and PN incidence when compared to oral LDopa alone (Andrasson et al

For those who have trouble absorbing Vitamin B12 from diet or supplements, long-term injections may be required

By inhibiting NNMT, 5-Amino-1MQ prevents the methylation of nicotinamide, which thus remains available for recycling to NAD+ via the salvage pathway

5-Amino-1MQ selectively inhibits NNMT (IC50 = 1.2 M), an enzyme that consumes nicotinamide by methylating it

[19] [21] Dosage adjustments may be necessary in patients with renal impairment, G6PD deficiency, or other comorbidities