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Another rare risk is hypokalemia (low potassium), with symptoms like muscle weakness and irregular heartbeat, which can occur when treatment begins for severe anemia

Multiple Sclerosis and Related Disorders 65: 104011

Our observation that intracellular NA concentrations did not increase following NNMT inhibition extends previous studies that showed NA concentrations were largely unaffected following NNMT knockdown with either adenovirus[39] or anti-sense oligonucleotides (ASOs).[12] It is possible that significant accumulation of NA in adipocytes (and other tissues) is prevented by rapid conversion of NA to NMN and subsequent NAD + synthesis or transport to the extracellular environment.[27] Importantly, NNMT inhibition potentiated the absolute intracellular concentrations of NAD + and SAM, without altering the levels of NA and SAH in the adipocytes

For your own safety, tell your doctor about all the medications you're currently taking, as some of them may interfere with the absorption of vitamin B12