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Kannt A, Pfenninger A, Teichert L, Tnjes A, Dietrich A, Schn MR, Klting N, Blher M. Association of nicotinamide-N-methyltransferase mRNA expression in human adipose tissue and the plasma concentration of its product, 1-methylnicotinamide, with insulin resistance. Diabetologia. 2015 Apr;58(4):799-808. doi: 10.1007/s00125-014-3490-7. Epub 2015 Jan 18. PMID: 25596852; PMCID: PMC4351435

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If after increasing the dosage unacceptable opioid-related adverse reactions are observed, (including an increase in pain after dosage increase), consider reducing the dosage [see Warnings]