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Patients experiencing persistent vomiting or diarrhea should be monitored for signs of dehydration and renal dysfunction, with appropriate fluid replacement and potentially temporary discontinuation of the medication if necessary

With MTRR/MTR inhibition, the compensation pathway is BHMT (betaine-homocysteine methyltransferase (betaine to dimethylglycine)

Pharmacokinetic studies in rats demonstrated an oral bioavailability of 38.4%, with a mean Cmax of 2,252 ng/mL and terminal elimination half-lives of 3.80 1.10 hours (IV) and 6.90 1.20 hours (oral) (Awosemo et al., 2021)

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Without the CKD code, the manifestation has no reference point and the claim fails