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The mechanism is not fully understood but may relate to changes in blood sugar regulation during sleep or the stimulatory effects of B12 in the compounded formulation
Other states permit open sales if labeling and sterility standards are met
If it must be administered in an emergency situation, the serotonergic drug should be immediately stopped, and the patient closely monitored for symptoms of CNS toxicity for two weeks (five weeks if fluoxetine was taken), or until 24 hours after the last dose of methylene blue, whichever comes first
Phenylalanine impairs insulin signaling and inhibits glucose uptake through modification of IR
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