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Citations [1] Kwon DR, Park GY

NNMT (nicotinamide N-methyltransferase) is an enzyme that methylates nicotinamide, diverting it from NAD+ synthesis

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In summary, the key interactions to consider are pyridoxines reduction of levodopa and anticonvulsant efficacy, niacinamides additive effects on blood pressure, blood sugar, and gout management, and the potential need for B-vitamin repletion in patients on certain medications (diuretics, isoniazid, etc.)