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Effects on maternal bone were observed in pregnant and lactating rats in a pre- and postnatal toxicity study when esomeprazole magnesium was administered at oral doses of 14 to 280 mg/kg/day (about 3.4 to 68 times an oral human dose of 40 mg on a body surface area basis)

When MUT activity is impaired due to genetic mutations or functional vitamin B12 deficiency, methylmalonyl-CoA cannot be efficiently converted into succinyl-CoA

With regular dosing, it takes about 48 hours to achieve a stable plasma drug level (61)