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Risperidone inhibits OCT1 and OCT2 major thiamine transporters that also convey choline

If these appear, reduce tirzepatide dose, pause 5-amino-1MQ, and increase caloric intake by 200400 kcal daily until symptoms resolve

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No published trials have specifically enrolled participants with hepatic or renal impairment, so safety in these populations is unknown

Those allergic to vitamin B12 or cobalt should avoid them