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[21] Within cells, cyanocobalamin is converted to methylcobalamin and 5- deoxyadenosylcobalamin, coenzymes that participate respectively in homocysteine remethylation to methionine and in the isomerization of methylmalonyl-CoA to succinyl CoA, reactions essential for DNA synthesis, erythropoiesis, and myelin maintenance

Your healthcare provider may also prescribe ondansetron (Zofran), a serotonin antagonist used in oncology and post-operative settings, at a low dose of 48 mg taken once or twice daily as needed

Patients who have used these medications are now encountering severe side effects, including a condition known as gastroparesis or stomach paralysis