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People who need extra caution include: Those with liver disease, including hepatitis or cirrhosis Those with heavy or regular alcohol use People with low body weight or malnutrition Those already taking multiple medicines, especially combinations containing paracetamol Infants, for whom dosing and formulation guidance must come from a doctor or pharmacist Use Only After Medical Advice In These Situations Liver disease (hepatitis, cirrhosis, or any liver condition) Regular or heavy alcohol use Malnutrition or very low body weight Chronic daily use for pain requires medical review of dose and underlying diagnosis People taking anticoagulants (blood thinners) or complex medication regimens Pregnancy use the lowest effective dose for the shortest time

If you're already using a DPP4 inhibitor, ask your doctor to prescribe a safe alternative such as metformin

However, some doctors prescribe vitamin B complex injections or other supplements containing vitamin B to improve the overall health of the patients

For patients with GI conditions that limit absorption, the difference is especially pronounced