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According to the MHRA/EMC Summary of Product Characteristics (SmPC), these include: Nausea and vomiting often most pronounced during dose escalation Diarrhoea or constipation affecting bowel regularity Abdominal pain and discomfort typically mild to moderate Reduced appetite a therapeutic effect that may feel uncomfortable initially Dyspepsia indigestion or heartburn These gastrointestinal effects usually diminish over time as the body adjusts to treatment

Methylmalonic acid level (MMA)

Vitamin B-12 (cyanocobalamin) is stored in the liver

Published studies on KPV in inflammatory bowel disease models report no adverse histological findings at doses producing anti-inflammatory effects [7,8]