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The product is prepared under regulatory oversight (state pharmacy boards inspect compounding pharmacies), but the documentation standard is not as uniform as FDA-registered manufacturing

Others spread the daily dose into 2-3 doses, taken in the morning and prior to physical exercise, in both cases on an empty stomach

However, individuals with absorption disorders may require significantly higher doses to achieve therapeutic levels

As a result, methylfolate is converted to tetrahydrofolate, which is required for purine synthesis which in turn is required for DNA synthesis

Assess both vitamin B12 and folate levels prior to initiating therapy with vitamin B12, including NASCOBAL, or with folic acid [see Dosage and Administration (2.1)]