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This depends on oxaloacetate production by the ACLY reaction, which is returned to the TCA cycle after conversion to malate by MDH1

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Precautions/Side Effects Speak with your healthcare provider if you are currently taking certain medications that can lower your blood levels of biotin, such as carbamazepine, phenobarbital, phenytoin, or primidone, or if you are currently on dialysis or taking chemotherapy

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