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This is probably explained by the fact that S-adenosylmethionine (SAM), which is important for many epigenetic processes, is regenerated by methylcobalamin, whereas cyanocobalamin reduces it (as we explored above)

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In these patients, administration of an NSAID may cause a dose-dependant reduction in prostaglandin formation and, secondarily, in renal blood flow, which may precipitate overt renal failure