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This reaction effectively diverts nicotinamide away from the NAD+ salvage pathway, reducing the cell's capacity to regenerate NAD+

Rat studies have noted embryofetal mortality, structural abnormalities, and alterations to growth at maternal exposures below the maximum recommended human dose (MRHD) based on exposure AUC

doi: 10.1016/S0140-6736(00)02755-0 132 Berlanga-AcostaJAbreu-CruzABarco HerreraDMendoza-MarYRodrguez-UlloaAGarca-OjalvoAet al

Root Cause: Some payers impose restrictions on how often CPT 96372 can be billed per patient, often without clear documentation of these limits

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