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Rapid or labored breathing

It works by inhibiting the enzyme NNMT (nicotinamide N-methyltransferase), which plays a role in energy metabolism and fat storage

Seek urgent same-day assessment or call 999 for emergency care if experiencing: Severe chest pain Severe shortness of breath Fainting or collapse Acute or rapidly worsening neurological deficits (such as new limb weakness, sudden gait disturbance, or bladder/bowel dysfunction) Persistent or worsening anaemia symptoms despite treatmentincluding breathlessness, chest discomfort, palpitations, or extreme fatigueshould trigger medical review

To achieve comparable effects, oral doses must be 30-50 times higher, creating cost and side effect challenges