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Frontiers | Modulating CD38 enzymatic activity during antibody-based immunotherapy in multiple myeloma: a basic science perspective

Concurrent Use with Other NNMT Inhibitors or Methylation Modulators Combining with supplements or drugs that also inhibit NNMT or alter methylation (e.g., SAMe , niacin , methylfolate , resveratrol ) could lead to: Excess NAD⁺ accumulation Methyl donor depletion Unpredictable metabolic effects ⚠️ Use caution and monitor methylation-related pathways if stacking ❌ 3

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Hepatic Enzyme Inducers (e.g., barbiturates, phenytoin, carbamazepine, rifampin): Drugs which induce cytochrome P450 3A4 enzyme activity may enhance the metabolism of corticosteroids and require that the dosage of the corticosteroid be increased