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The addition of niacinamide to the formula soothes inflammation and reduces the visibility of enlarged openings of sebaceous glands, the so-called pores, and also prevents the formation of discoloration

Inefficient metabolism in the medulla due to a lack of thiamine can result in abnormal activity of the vagus nerve and autonomic dysfunction, which have numerous downstream effects on the gastrointestinal system

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The 2024 NICE Guideline NG239 from the United Kingdoms National Institute for Health and Care Excellence similarly distinguishes between patients who can be managed with oral therapy and those who require intramuscular treatment