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Neomycin, colchicine, para-aminosalicylic acid, or excessive alcohol intake longer than two weeks may cause malabsorption of vitamin B12. Chloramphenicol and other drugs having bone marrow suppressant properties may cause a lack of therapeutic response to vitamin B12

This is the gold-standard way to answer does the oral form actually get in. What they found: ~38.4% oral bioavailability, with a half-life around 6.9 hours oral and 3.8 hours IV

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Rather than directly supplying NAD+ precursors (like NMN or NR), it works by blocking an enzyme that consumes nicotinamide, theoretically preserving the substrate pool for endogenous NAD+ production

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